Finance issue brief: health care claims payment: prompt payment: year end report-2003.

PubMed

MacEachern, Lillian

2003-12-31

Since the mid 1990's state legislators and regulators have worked to resolve the complex issue of timely payment of health care claims. They have been challenged with bridging the communication gap between provider and payor and forced to address such base problems as what determines a correctly billed service. As time has progressed it is ever apparent that the completion of payment for services is dependent on many variables, not just simply timely processing of a claim.

7 CFR 81.10 - Claim for payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROGRAMS PRUNE/DRIED PLUM DIVERSION PROGRAM § 81.10 Claim for payment. (a) To obtain payment for the trees... Committee. Such form shall include the Committee's certification that the qualifying trees from the blocks... check to the producer in the amount of $8.50 per eligible tree removed. (b) [Reserved] ...

7 CFR 81.10 - Claim for payment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... check to the producer in the amount of $8.50 per eligible tree removed. (b) [Reserved] ... PROGRAMS PRUNE/DRIED PLUM DIVERSION PROGRAM § 81.10 Claim for payment. (a) To obtain payment for the trees... Committee. Such form shall include the Committee's certification that the qualifying trees from the blocks...

7 CFR 81.10 - Claim for payment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... check to the producer in the amount of $8.50 per eligible tree removed. (b) [Reserved] ... PROGRAMS PRUNE/DRIED PLUM DIVERSION PROGRAM § 81.10 Claim for payment. (a) To obtain payment for the trees... Committee. Such form shall include the Committee's certification that the qualifying trees from the blocks...

7 CFR 81.10 - Claim for payment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... check to the producer in the amount of $8.50 per eligible tree removed. (b) [Reserved] ... PROGRAMS PRUNE/DRIED PLUM DIVERSION PROGRAM § 81.10 Claim for payment. (a) To obtain payment for the trees... Committee. Such form shall include the Committee's certification that the qualifying trees from the blocks...

7 CFR 81.10 - Claim for payment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... check to the producer in the amount of $8.50 per eligible tree removed. (b) [Reserved] ... PROGRAMS PRUNE/DRIED PLUM DIVERSION PROGRAM § 81.10 Claim for payment. (a) To obtain payment for the trees... Committee. Such form shall include the Committee's certification that the qualifying trees from the blocks...

39 CFR 601.110 - Payment of claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.110 Payment of claims. Any claim amount determined in a final decision to be payable, less any portion previously paid, should be promptly.... In the absence of appeal by the Postal Service, a board or court decision favorable in whole or in...

40 CFR 14.9 - Approval and payment of claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... employee by persons specified in § 14.5 in the following order: (1) The spouse's claim. (2) A child's claim... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Approval and payment of claims. 14.9 Section 14.9 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL EMPLOYEE PERSONAL PROPERTY...

Medicare program; Part B advance payments to suppliers furnishing items or services under Medicare Part B--HCFA. Final rule.

PubMed

1996-09-19

This rule establishes requirements and procedures for advance payments to suppliers of Medicare Part B services. An advance payment will be made only if the carrier is unable to process a claim timely; the supplier requests advance payment; we determine that payment of interest is insufficient to compensate the supplier for loss of the use of the funds; and, we expressly approve the advance payment in writing. These rules are necessary to address deficiencies noted by the General Accounting Office in its report analyzing current procedures for making advance payments. The intent of this rule is to ensure more efficient and effective administration of this aspect of the Medicare program.

20 CFR 404.2116 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 404.2116 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

20 CFR 416.2216 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 416.2216 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

20 CFR 416.2216 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 416.2216 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

20 CFR 404.2116 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 404.2116 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

20 CFR 416.2216 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 416.2216 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

20 CFR 416.2216 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 416.2216 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

20 CFR 404.2116 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 404.2116 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

20 CFR 404.2116 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 404.2116 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

20 CFR 404.2116 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 404.2116 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

20 CFR 416.2216 - When claims for payment for VR services must be made (filing deadlines).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false When claims for payment for VR services must... Rehabilitation Services Payment Provisions § 416.2216 When claims for payment for VR services must be made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each...

32 CFR 270.12 - Payment in full satisfaction of all claims against the United States.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Payment in full satisfaction of all claims... INCARCERATED BY THE DEMOCRATIC REPUBLIC OF VIETNAM Payment § 270.12 Payment in full satisfaction of all claims... part shall constitute full satisfaction of all claims by or on behalf of that person against the United...

50 CFR 296.13 - Payment of award for claim.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Payment of award for claim. 296.13 Section 296.13 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE CONTINENTAL SHELF FISHERMEN'S CONTINGENCY FUND § 296.13 Payment of award...

5 CFR 890.105 - Filing claims for payment or service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administration and General Provisions § 890.105 Filing claims for payment or service. (a) General. (1) Each health benefits carrier resolves claims filed under the plan. All health benefits claims must be submitted initially to the carrier of the...

44 CFR 206.205 - Payment of claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Payment of claims. 206.205 Section 206.205 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Public Assistance Project Administration...

9 CFR 50.20 - Claims for payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Claims for payment. 50.20 Section 50.20 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE COOPERATIVE CONTROL AND ERADICATION OF LIVESTOCK OR POULTRY DISEASES ANIMALS DESTROYED BECAUSE OF TUBERCULOSIS...

9 CFR 50.20 - Claims for payment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Claims for payment. 50.20 Section 50.20 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE COOPERATIVE CONTROL AND ERADICATION OF LIVESTOCK OR POULTRY DISEASES ANIMALS DESTROYED BECAUSE OF TUBERCULOSIS...

9 CFR 50.20 - Claims for payment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Claims for payment. 50.20 Section 50.20 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE COOPERATIVE CONTROL AND ERADICATION OF LIVESTOCK OR POULTRY DISEASES ANIMALS DESTROYED BECAUSE OF TUBERCULOSIS...

9 CFR 50.20 - Claims for payment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Claims for payment. 50.20 Section 50.20 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE COOPERATIVE CONTROL AND ERADICATION OF LIVESTOCK OR POULTRY DISEASES ANIMALS DESTROYED BECAUSE OF TUBERCULOSIS...

9 CFR 50.20 - Claims for payment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Claims for payment. 50.20 Section 50.20 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE COOPERATIVE CONTROL AND ERADICATION OF LIVESTOCK OR POULTRY DISEASES ANIMALS DESTROYED BECAUSE OF TUBERCULOSIS...

45 CFR 507.1 - Payments under the War Claims Act of 1948, as amended by Public Law 91-289.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Payments under the War Claims Act of 1948, as..., ADMINISTRATION, AND PAYMENT OF CLAIMS UNDER TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED PAYMENT § 507.1 Payments under the War Claims Act of 1948, as amended by Public Law 91-289. (a) Upon a determination by the...

7 CFR 4288.133 - Payment liability.

Code of Federal Regulations, 2014 CFR

2014-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... to any claim or lien against the advanced biofuel, or proceeds thereof, in favor of the owner or any...

25 CFR 117.28 - Payment of claims against estates.

Code of Federal Regulations, 2010 CFR

2010-04-01

... COMPETENCY § 117.28 Payment of claims against estates. The superintendent may disburse to the executor or... of competency at the time of his death sufficient funds out of the estate to pay the following...

24 CFR 232.256 - Partial payment of claims.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Partial payment of claims. 232.256 Section 232.256 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN...

24 CFR 232.256 - Partial payment of claims.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Partial payment of claims. 232.256 Section 232.256 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN...

76 FR 7935 - Advanced Biofuel Payment Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

...The Rural Business-Cooperative Service (Agency) is establishing the Advanced Biofuel Payment Program authorized under the Food, Conservation, and Energy Act of 2008. Under this Program, the Agency will enter into contracts with advanced biofuel producers to pay such producers for the production of eligible advanced biofuels. To be eligible for payments, advanced biofuels must be produced from renewable biomass, excluding corn kernel starch, in a biofuel facility located in a State. In addition, this interim rule establishes new program requirements for applicants to submit applications for Fiscal Year 2010 payments for the Advanced Biofuel Payment Program. These new program requirements supersede the Notice of Contract Proposal (NOCP) for Payments to Eligible Advanced Biofuel Producers in its entirety.

7 CFR 1450.8 - Payments not subject to claims.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Payments not subject to claims. 1450.8 Section 1450.8 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP ASSISTANCE PROGRAM (BCAP) Common...

7 CFR 1450.8 - Payments not subject to claims.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Payments not subject to claims. 1450.8 Section 1450.8 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP ASSISTANCE PROGRAM (BCAP) Common...

7 CFR 1450.8 - Payments not subject to claims.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Payments not subject to claims. 1450.8 Section 1450.8 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP ASSISTANCE PROGRAM (BCAP) Common...

7 CFR 1450.8 - Payments not subject to claims.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Payments not subject to claims. 1450.8 Section 1450.8 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP ASSISTANCE PROGRAM (BCAP) Common...

Comparison of Medicaid Payments Relative to Medicare Using Inpatient Acute Care Claims from the Medicaid Program: Fiscal Year 2010-Fiscal Year 2011.

PubMed

Stone, Devin A; Dickensheets, Bridget A; Poisal, John A

2018-02-01

To compare Medicaid fee-for-service (FFS) inpatient hospital payments to expected Medicare payments. Medicaid and Medicare claims data, Medicare's MS-DRG grouper and inpatient prospective payment system pricer (IPPS pricer). Medicaid FFS inpatient hospital claims were run through Medicare's MS-DRG grouper and IPPS pricer to compare Medicaid's actual payment against what Medicare would have paid for the same claim. Average inpatient hospital claim payments for Medicaid were 68.8 percent of what Medicare would have paid in fiscal year 2010, and 69.8 percent in fiscal year 2011. Including Medicaid disproportionate share hospital (DSH), graduate medical education (GME), and supplemental payments reduces a substantial proportion of the gap between Medicaid and Medicare payments. Medicaid payments relative to expected Medicare payments tend to be lower and vary by state Medicaid program, length of stay, and whether payments made outside of the Medicaid claims process are included. © Health Research and Educational Trust.

32 CFR 199.7 - Claims submission, review, and payment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Claims submission, review, and payment. 199.7 Section 199.7 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE... patient's treatment and progress. Accurate and timely completion of orders, notes, etc., enable different...

47 CFR 0.469 - Advance payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Advance payments. 0.469 Section 0.469 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION General Information Public Information and Inspection of Records § 0.469 Advance payments. (a) The Commission may not require advance...

47 CFR 0.469 - Advance payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Advance payments. 0.469 Section 0.469 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION General Information Public Information and Inspection of Records § 0.469 Advance payments. (a) The Commission may not require advance...

47 CFR 0.469 - Advance payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Advance payments. 0.469 Section 0.469 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION General Information Public Information and Inspection of Records § 0.469 Advance payments. (a) The Commission may not require advance...

48 CFR 252.232-7000 - Advance payment pool.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Advance payment pool. 252... Provisions And Clauses 252.232-7000 Advance payment pool. As prescribed in 232.412-70(a), use the following clause: Advance Payment Pool (DEC 1991) (a) Notwithstanding any other provision of this contract, advance...

78 FR 53014 - Agency Information Collection (Claim for One Sum Payment (Government Life Insurance)) Activities...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... for One Sum Payment (Government Life Insurance)) Activities Under OMB Review AGENCY: Veterans Benefits....'' SUPPLEMENTARY INFORMATION Titles: a. Claim for One Sum Payment (Government Life Insurance), VA Form 29-4125. [[Page 53015

25 CFR 273.43 - Advance payments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Advance payments. 273.43 Section 273.43 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT PROGRAM EDUCATION CONTRACTS UNDER JOHNSON-O'MALLEY ACT General Contract Requirements § 273.43 Advance payments...

25 CFR 273.43 - Advance payments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Advance payments. 273.43 Section 273.43 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT PROGRAM EDUCATION CONTRACTS UNDER JOHNSON-O'MALLEY ACT General Contract Requirements § 273.43 Advance payments...

25 CFR 273.43 - Advance payments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Advance payments. 273.43 Section 273.43 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT PROGRAM EDUCATION CONTRACTS UNDER JOHNSON-O'MALLEY ACT General Contract Requirements § 273.43 Advance payments...

25 CFR 273.43 - Advance payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Advance payments. 273.43 Section 273.43 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT PROGRAM EDUCATION CONTRACTS UNDER JOHNSON-O'MALLEY ACT General Contract Requirements § 273.43 Advance payments...

25 CFR 273.43 - Advance payments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Advance payments. 273.43 Section 273.43 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT PROGRAM EDUCATION CONTRACTS UNDER JOHNSON-O'MALLEY ACT General Contract Requirements § 273.43 Advance payments...

25 CFR 213.19 - Crediting advance annual payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... been made. No refund of such advance payments made under any lease will be allowed in the event the royalty on production is not sufficient to equal such advance payment; nor will any part of the moneys so... 25 Indians 1 2010-04-01 2010-04-01 false Crediting advance annual payments. 213.19 Section 213.19...

7 CFR 28.125 - No voiding or modifying claims for payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 28.125 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD... Standards Act Fees and Costs § 28.125 No voiding or modifying claims for payment. Nothing in this subpart...

TRICARE revision to CHAMPUS DRG-based payment system, pricing of hospital claims. Final rule.

PubMed

2014-05-21

This Final rule changes TRICARE's current regulatory provision for inpatient hospital claims priced under the DRG-based payment system. Claims are currently priced by using the rates and weights that are in effect on a beneficiary's date of admission. This Final rule changes that provision to price such claims by using the rates and weights that are in effect on a beneficiary's date of discharge.

Does a global budget superimposed on fee-for-service payments mitigate hospitals' medical claims in Taiwan?

PubMed

Hsu, Pi-Fem

2014-12-01

Taiwan's global budgeting for hospital health care, in comparison to other countries, assigns a regional budget cap for hospitals' medical benefits claimed on the basis of fee-for-service (FFS) payments. This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000-2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals' responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regional budget cap superimposed on FFS payments provides only blunt incentive to the hospitals to cooperate to contain medical resource utilization, unless a monitoring mechanism attached with the payment system.

76 FR 24343 - Advanced Biofuel Payment Program; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

...-AA75 Advanced Biofuel Payment Program; Correction AGENCY: Rural Business-Cooperative Service; Rural... Federal Register of February 11, 2011, establishing the Advanced Biofuel Payment Program authorized under... this Program, the Agency will enter into contracts with advanced biofuel producers to pay such...

14 CFR 1206.704 - Advance payments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... where the requester has a history of prompt payment of FOIA fees, or require an advance payment of an amount up to the full estimated charges in the case of requesters with no history of payment; or (2) A requester has previously failed to pay a fee in a timely fashion (within 30 days of billing), then NASA may...

24 CFR 2002.15 - Advance payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... where the requester has a history of prompt payment of FOIA fees, or require an advance payment of an amount up to the full estimated charges in the case of requesters with no history of payment; or (2) Where a requester has previously failed to pay a fee charged in a timely fashion (i.e., within 30 days...

48 CFR 728.105-1 - Advance payment bonds.

Code of Federal Regulations, 2011 CFR

2011-10-01

....105-1 Section 728.105-1 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Bonds 728.105-1 Advance payment bonds. (a) Generally, advance payment bonds will not be required in connection with USAID contracts containing an advance...

48 CFR 728.105-1 - Advance payment bonds.

Code of Federal Regulations, 2010 CFR

2010-10-01

....105-1 Section 728.105-1 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Bonds 728.105-1 Advance payment bonds. (a) Generally, advance payment bonds will not be required in connection with USAID contracts containing an advance...

48 CFR 32.408 - Application for advance payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... amount of advance payments. (4) The name and address of the financial institution at which the contractor... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Application for advance... GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Advance Payments for Non-Commercial Items 32.408...

14 CFR 1206.704 - Advance payments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF THE PUBLIC Search, Review, and Duplication Fees § 1206.704 Advance payments. (a) NASA will not... request, unless: (1) NASA estimates or determines that the allowable charges are likely to exceed $250. NASA will notify the requester of the likely cost and obtain satisfactory assurance of full payment...

14 CFR 1206.704 - Advance payments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF THE PUBLIC Search, Review, and Duplication Fees § 1206.704 Advance payments. (a) NASA will not... request, unless: (1) NASA estimates or determines that the allowable charges are likely to exceed $250. NASA will notify the requester of the likely cost and obtain satisfactory assurance of full payment...

14 CFR 1206.704 - Advance payments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF THE PUBLIC Search, Review, and Duplication Fees § 1206.704 Advance payments. (a) NASA will not... request, unless: (1) NASA estimates or determines that the allowable charges are likely to exceed $250. NASA will notify the requester of the likely cost and obtain satisfactory assurance of full payment...

43 CFR 5461.1 - Payment in advance of cutting or removal.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Payment in advance of cutting or removal... Payments § 5461.1 Payment in advance of cutting or removal. Except as provided in §§ 5451.2 and 5451.4 no part of any timber or other vegetative resources sold may be cut or removed unless advance payment has...

34 CFR 5.62 - Advance payment of fees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... anticipated cost and obtains satisfactory assurance of full payment if the requester has a history of prompt payment of FOIA fees; or (2) Requires an advance payment if the requester has no history of payment. (b) If a requester has previously failed to pay a fee in a timely fashion, the FOI Officer does not...

Claims, liabilities, injures and compensation payments of medical malpractice litigation cases in China from 1998 to 2011.

PubMed

Li, Heng; Wu, Xiangcheng; Sun, Tao; Li, Li; Zhao, Xiaowen; Liu, Xinyan; Gao, Lei; Sun, Quansheng; Zhang, Zhong; Fan, Lihua

2014-09-13

Although China experienced great improvement in their health system, disputes between patients and doctors have increasingly intensified, reaching an unprecedented level. Retrospective analysis of medical malpractice litigation can discover the characteristics and fundamental cause of these disagreements. We analyzed medical malpractice litigation data from 1998 to 2011 for characteristics of claims via a litigation database within a nationwide database of cases (1086 cases) in China, including claims, liabilities, injures, and compensation payments. Among the cases analyzed, 76 percent of claims received compensation in civil judgment (640 out of 841), while 93 percent were fault liability in paid judgment (597 out of 640). The average time span between the occurrence of the injury dispute and closure of claims was 3 years. Twenty-two percent of claims (183 of 841) were caused by injury, poisoning, and other external causes. Seventy-nine percent of claims (472 of 597) were contributed to by errors in medical technology. The median damage compensation payment for death was significantly lower than for serious injuries (P < 0.001; death, $13270 [IQR, $7617-$23181]; serious injury, $23721 [IQR, $10367-$57058]). Finally, there was no statistically significant difference in the median mental compensation between minor injury, serious injury, and death (P = 0.836). The social reasons for the conflict and high payment were catastrophic out-of-pocket health-care expense in addition to the high expectations for treatment in China. There were no distinguishing features between China and other countries with respect to time of suits, facilities, and specialties in these claims. The compensation for damages in different medical injuries was unfair in China.

20 CFR 30.510 - How does OWCP notify an individual of a payment made on a claim?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How does OWCP notify an individual of a payment made on a claim? 30.510 Section 30.510 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... AMENDED Survivors; Payments and Offsets; Overpayments Overpayments § 30.510 How does OWCP notify an...

42 CFR 424.40 - Request for payment effective for more than one claim.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the first claim for home health services or outpatient physical therapy or speech pathology services... or outpatient physical therapy or speech pathology services furnished by the provider under that plan... for payment statement prescribed by CMS and signed by the beneficiary (or by his or her representative...

7 CFR 1486.406 - Will CCC make advance payments to Recipients?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Will CCC make advance payments to Recipients? 1486... Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC may make advance payments to a...

7 CFR 1486.406 - Will CCC make advance payments to Recipients?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Will CCC make advance payments to Recipients? 1486... Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC may make advance payments to a...

7 CFR 1486.406 - Will CCC make advance payments to Recipients?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Will CCC make advance payments to Recipients? 1486... Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC may make advance payments to a...

41 CFR 302-17.10 - Claims for payment and supporting documentation and verification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... supporting documentation and verification. 302-17.10 Section 302-17.10 Public Contracts and Property... INCOME TAX (RIT) ALLOWANCE § 302-17.10 Claims for payment and supporting documentation and verification..., net earnings (or loss) from self-employment income shown on attached Schedule SE (Form 1040): Form(s)W...

41 CFR 102-118.475 - Does interest apply after certification of payment of claims?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Claims and Appeal Procedures General Agency Information for... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Does interest apply...

43 CFR 30.142 - Will a judge authorize payment of a claim from the trust estate if the decedent's non-trust...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Will a judge authorize payment of a claim from the trust estate if the decedent's non-trust estate was or is available? 30.142 Section 30.142 Public Lands: Interior Office of the Secretary of the Interior INDIAN PROBATE HEARINGS PROCEDURES Claims § 30.142 Will a judge authorize payment of a...

32 CFR 538.6 - Claims.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Claims. 538.6 Section 538.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS MILITARY PAYMENT CERTIFICATES § 538.6 Claims. Claims for conversion of military payment certificates, as well as claims arising out of...

14 CFR § 1206.704 - Advance payments.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) NASA will not require a requester to make an advance payment, i.e., payment before work is commenced or continued on a request, unless: (1) NASA estimates or determines that the allowable charges are likely to exceed $250. NASA will notify the requester of the likely cost and obtain satisfactory assurance of full...

77 FR 43083 - Federal Acquisition Regulation; Information Collection; Advance Payments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-23

...; Information Collection; Advance Payments AGENCIES: Department of Defense (DOD), General Services... Paperwork Reduction Act, the Regulatory Secretariat will be submitting to the Office of Management and... requirement concerning advance payments. Public comments are particularly invited on: Whether this collection...

14 CFR 440.19 - United States payment of excess third-party liability claims.

Code of Federal Regulations, 2010 CFR

2010-01-01

... insurance required under § 440.9(b); and (2) Is not more than $1,500,000,000 (as adjusted for inflation... reasonable rates. The licensee must submit a certification in accordance with § 440.15(c)(1)(iii) of this... inflation occurring after January 1, 1989). (e) Payment by the United States of excess third-party claims...

Development of a claim review and payment model utilizing diagnosis related groups under the Korean health insurance.

PubMed

Shin, Y S; Yeom, Y K; Hwang, H

1993-02-01

This paper describes the development of a claim review and payment model utilizing the diagnosis related groups (DRGs) for the fee for service-based payment system of the Korean health insurance. The present review process, which examines all claims manually on a case-by-case basis, has been considered to be inefficient, costly, and time-consuming. Differences in case mix among hospitals are controlled in the proposed model using the Korean DRGs. They were developed by modifying the US-DRG system. An empirical test of the model indicated that it can enhance the efficiency as well as the credibility and objectivity of the claim review. Furthermore, it is expected that it can contribute effectively to medical cost containments and to optimal practice pattern of hospitals by establishing a useful mechanism in monitoring the performance of hospitals. However, the performance of this model needs to be upgraded by refining the Korean DRGs which play a key role in the model.

38 CFR 10.25 - Payment of death claim on adjusted service certificate without bond.

Code of Federal Regulations, 2011 CFR

2011-07-01

... certificate, issued pursuant to the provisions of section 501 of the World War Adjusted Compensation Act, is... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Payment of death claim on adjusted service certificate without bond. 10.25 Section 10.25 Pensions, Bonuses, and Veterans' Relief...

38 CFR 10.25 - Payment of death claim on adjusted service certificate without bond.

Code of Federal Regulations, 2012 CFR

2012-07-01

... certificate, issued pursuant to the provisions of section 501 of the World War Adjusted Compensation Act, is... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Payment of death claim on adjusted service certificate without bond. 10.25 Section 10.25 Pensions, Bonuses, and Veterans' Relief...

38 CFR 10.25 - Payment of death claim on adjusted service certificate without bond.

Code of Federal Regulations, 2014 CFR

2014-07-01

... certificate, issued pursuant to the provisions of section 501 of the World War Adjusted Compensation Act, is... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Payment of death claim on adjusted service certificate without bond. 10.25 Section 10.25 Pensions, Bonuses, and Veterans' Relief...

38 CFR 10.25 - Payment of death claim on adjusted service certificate without bond.

Code of Federal Regulations, 2013 CFR

2013-07-01

... certificate, issued pursuant to the provisions of section 501 of the World War Adjusted Compensation Act, is... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Payment of death claim on adjusted service certificate without bond. 10.25 Section 10.25 Pensions, Bonuses, and Veterans' Relief...

38 CFR 10.25 - Payment of death claim on adjusted service certificate without bond.

Code of Federal Regulations, 2010 CFR

2010-07-01

... certificate, issued pursuant to the provisions of section 501 of the World War Adjusted Compensation Act, is... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Payment of death claim on adjusted service certificate without bond. 10.25 Section 10.25 Pensions, Bonuses, and Veterans' Relief...

Malpractice claims for endoscopy

PubMed Central

Hernandez, Lyndon V; Klyve, Dominic; Regenbogen, Scott E

2013-01-01

AIM: To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure. METHODS: We obtained data from a comprehensive database of closed claims from a trade association of professional liability insurance carriers, representing over 60% of practicing United States physicians. Total payments by procedure and year were calculated, and were adjusted for inflation (using the Consumer Price Index) to 2008 dollars. Time series analysis was performed to assess changes in the total value of claims for each type of procedure over time. RESULTS: There were 1901 endoscopy-related closed claims against all providers from 1985 to 2008. The specialties include: internal medicine (n = 766), gastroenterology (n = 562), general surgery (n = 231), general and family practice (n = 101), colorectal surgery (n = 87), other specialties (n = 132), and unknown (n = 22). Colonoscopy represented the highest frequencies of closed claims (n = 788) and the highest total indemnities ($54 093 000). In terms of mean claims payment, endoscopic retrograde cholangiopancreatography (ERCP) ranked the highest ($374  794) per claim. Internists had the highest number of total claims (n = 766) and total claim payment ($70  730  101). Only total claim payments for colonoscopy and ERCP seem to have increased over time. Indeed, there was an average increase of 15.5% per year for colonoscopy and 21.9% per year for ERCP after adjusting for inflation. CONCLUSION: There appear to be differences in malpractice coverage costs among specialties and the type of endoscopic procedure. There is also evidence for secular trend in total claim payments, with colonoscopy and ERCP costs rising yearly even after adjusting for inflation. PMID:23596540

40 CFR Appendix D to Part 307 - Notice of Limitations on the Payment of Claims for Response Actions Which Is To Be Placed in...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Notice of Limitations on the Payment of Claims for Response Actions Which Is To Be Placed in Public Dockets D Appendix D to Part 307... (CERCLA) CLAIMS PROCEDURES Pt. 307, App. D Appendix D to Part 307—Notice of Limitations on the Payment of...

26 CFR 1.451-5 - Advance payments for goods and long-term contracts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... accounting for tax purposes if such method results in including advance payments in gross receipts no later... the case of a taxpayer accounting for advance payments for tax purposes pursuant to a long-term contract method of accounting under § 1.460-4, or of a taxpayer accounting for advance payments with...

48 CFR 18.121 - Advance payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Law 85-804 (see Subpart 50.1, Extraordinary Contractual Actions). These advance payments may be made at or after award of sealed bid contracts, as well as negotiated contracts. (See 32.405.) [71 FR...

28 CFR 0.154 - Advance and evacuation payments and special allowances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Advance and evacuation payments and... Advance and evacuation payments and special allowances. The Director of the Federal Bureau of... Marshals Service, and the Director of the Office of Justice Assistance, Research and Statistics, as to...

42 CFR 431.972 - Claims sampling procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe. (1) The PERM claims universe includes payments that were originally paid (paid claims) and for which... must establish controls to ensure FFS and managed care universes are accurate and complete, including...

42 CFR 431.972 - Claims sampling procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe. (1) The PERM claims universe includes payments that were originally paid (paid claims) and for which... must establish controls to ensure FFS and managed care universes are accurate and complete, including...

42 CFR 431.972 - Claims sampling procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe. (1) The PERM claims universe includes payments that were originally paid (paid claims) and for which... must establish controls to ensure FFS and managed care universes are accurate and complete, including...

7 CFR 1486.406 - Will CCC make advance payments to Recipients?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Will CCC make advance payments to Recipients? 1486... PROGRAM Contributions and Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC...

7 CFR 1486.406 - Will CCC make advance payments to Recipients?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Will CCC make advance payments to Recipients? 1486... PROGRAM Contributions and Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC...

25 CFR 170.615 - Can a tribe receive advance payments for non-construction activities?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Can a tribe receive advance payments for non-construction... Agreements Under Isdeaa § 170.615 Can a tribe receive advance payments for non-construction activities? Yes. BIA must make advance payments to a tribe for non-construction activities under 25 U.S.C. 450l for...

25 CFR 170.615 - Can a tribe receive advance payments for non-construction activities?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Can a tribe receive advance payments for non-construction... Agreements Under Isdeaa § 170.615 Can a tribe receive advance payments for non-construction activities? Yes. BIA must make advance payments to a tribe for non-construction activities under 25 U.S.C. 450l for...

5 CFR 1651.18 - Payment to one bars payment to another.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Payment to one bars payment to another... BENEFITS § 1651.18 Payment to one bars payment to another. Payment made to a beneficiary(ies) in accordance with this part, based upon information received before payment, bars any claim by any other person. ...

28 CFR 32.16 - Payment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Payment. 32.16 Section 32.16 Judicial Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS Death Benefit Claims § 32.16 Payment. (a) No payment shall be made to (or on behalf of...

36 CFR 223.34 - Advance payment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Advance payment. 223.34 Section 223.34 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER, SPECIAL FOREST PRODUCTS, AND FOREST BOTANICAL PRODUCTS Timber...

36 CFR 223.34 - Advance payment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Advance payment. 223.34 Section 223.34 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER, SPECIAL FOREST PRODUCTS, AND FOREST BOTANICAL PRODUCTS Timber...

36 CFR 223.223 - Advance payment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Advance payment. 223.223 Section 223.223 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER, SPECIAL FOREST PRODUCTS, AND FOREST BOTANICAL PRODUCTS Special...

36 CFR 223.34 - Advance payment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Advance payment. 223.34 Section 223.34 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER, SPECIAL FOREST PRODUCTS, AND FOREST BOTANICAL PRODUCTS Timber...

36 CFR 223.34 - Advance payment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Advance payment. 223.34 Section 223.34 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER, SPECIAL FOREST PRODUCTS, AND FOREST BOTANICAL PRODUCTS Timber...

38 CFR 21.5135 - Advance payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Advance payments. 21.5135 Section 21.5135 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-Vietnam Era Veterans' Educational Assistance Under 38 U.S.C...

38 CFR 21.5135 - Advance payments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Advance payments. 21.5135 Section 21.5135 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-Vietnam Era Veterans' Educational Assistance Under 38 U.S.C...

38 CFR 21.5135 - Advance payments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Advance payments. 21.5135 Section 21.5135 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-Vietnam Era Veterans' Educational Assistance Under 38 U.S.C...

38 CFR 21.5135 - Advance payments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Advance payments. 21.5135 Section 21.5135 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-Vietnam Era Veterans' Educational Assistance Under 38 U.S.C...

38 CFR 21.5135 - Advance payments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Advance payments. 21.5135 Section 21.5135 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-Vietnam Era Veterans' Educational Assistance Under 38 U.S.C...

28 CFR 32.26 - Payment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Payment. 32.26 Section 32.26 Judicial Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS Disability Benefit Claims § 32.26 Payment. The amount payable on a claim shall be the...

28 CFR 32.26 - Payment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Payment. 32.26 Section 32.26 Judicial Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS Disability Benefit Claims § 32.26 Payment. The amount payable on a claim shall be the...

75 FR 21191 - Subpart B-Advanced Biofuel Payment Program; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... Service 7 CFR Part 4288 RIN 0570-AA75 Subpart B--Advanced Biofuel Payment Program; Correction AGENCY... for producers of advanced biofuels to supporting existing advanced biofuel production and to encourage...

78 FR 5449 - Federal Acquisition Regulation; Submission of OMB Review; Advance Payments

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-25

...; Submission of OMB Review; Advance Payments AGENCIES: Department of Defense (DOD), General Services... Paperwork Reduction Act, the Regulatory Secretariat will be submitting to the Office of Management and... requirement concerning advance payments. A notice was published in the Federal Register at 77 FR 43083, on...

7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Will FAS make advance payments to a Cooperator? 1484... FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a reimbursable basis...

7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Will FAS make advance payments to a Cooperator? 1484... FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a reimbursable basis...

7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Will FAS make advance payments to a Cooperator? 1484... FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a reimbursable basis...

Challenges in provider payment under the Ghana National Health Insurance Scheme: a case study of claims management in two districts.

PubMed

Sodzi-Tettey, S; Aikins, M; Awoonor-Williams, J K; Agyepong, I A

2012-12-01

In 2004, Ghana started implementing a National Health Insurance Scheme (NHIS) to remove cost as a barrier to quality healthcare. Providers were initially paid by fee - for - service. In May 2008, this changed to paying providers by a combination of Ghana - Diagnostic Related Groupings (G-DRGs) for services and fee - for - service for medicines through the claims process. The study evaluated the claims management processes for two District MHIS in the Upper East Region of Ghana. Retrospective review of secondary claims data (2008) and a prospective observation of claims management (2009) were undertaken. Qualitative and quantitative approaches were used for primary data collection using interview guides and checklists. The reimbursements rates and value of rejected claims were calculated and compared for both districts using the z test. The null hypothesis was that no differences existed in parameters measured. Claims processes in both districts were similar and predominantly manual. There were administrative capacity, technical, human resource and working environment challenges contributing to delays in claims submission by providers and vetting and payment by schemes. Both Schemes rejected less than 1% of all claims submitted. Significant differences were observed between the Total Reimbursement Rates (TRR) and the Total Timely Reimbursement Rates (TTRR) for both schemes. For TRR, 89% and 86% were recorded for Kassena Nankana and Builsa Schemes respectively while for TTRR, 45% and 28% were recorded respectively. Ghana's NHIS needs to reform its provider payment and claims submission and processing systems to ensure simpler and faster processes. Computerization and investment to improve the capacity to administer for both purchasers and providers will be key in any reform.

7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Will FAS make advance payments to a Cooperator? 1484... DEVELOP FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a...

7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Will FAS make advance payments to a Cooperator? 1484... DEVELOP FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a...

48 CFR 52.232-12 - Advance Payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... subcontractors for experimental, developmental, or research work. (3) If interest is required under the contract... each request for advance payments is true and correct. (8) These representations shall be continuing... nonprofit educational or research subcontractors for experimental, developmental, or research work...

48 CFR 52.232-12 - Advance Payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... subcontractors for experimental, developmental, or research work. (3) If interest is required under the contract... each request for advance payments is true and correct. (8) These representations shall be continuing... nonprofit educational or research subcontractors for experimental, developmental, or research work...

48 CFR 52.232-12 - Advance Payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... subcontractors for experimental, developmental, or research work. (3) If interest is required under the contract... each request for advance payments is true and correct. (8) These representations shall be continuing... nonprofit educational or research subcontractors for experimental, developmental, or research work...

48 CFR 52.232-12 - Advance Payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... subcontractors for experimental, developmental, or research work. (3) If interest is required under the contract... each request for advance payments is true and correct. (8) These representations shall be continuing... nonprofit educational or research subcontractors for experimental, developmental, or research work...

48 CFR 52.232-12 - Advance Payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... subcontractors for experimental, developmental, or research work. (3) If interest is required under the contract... each request for advance payments is true and correct. (8) These representations shall be continuing... nonprofit educational or research subcontractors for experimental, developmental, or research work...

48 CFR 32.405 - Applying Pub. L. 85-804 to advance payments under sealed bid contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... advance payments under sealed bid contracts. 32.405 Section 32.405 Federal Acquisition Regulations System... Non-Commercial Items 32.405 Applying Pub. L. 85-804 to advance payments under sealed bid contracts. (a... provisions of law relating to contracts, as explained in 50.101-1(a), also include making advance payments...

Enforcing prompt-payment regulations: the Texas approach.

PubMed

McCoy, Jim E; Han, Michael C; Malloy, Michael S

2002-07-01

To ensure that insurance carriers pay providers in a timely manner, Texas has adopted strict payment regulations. Enforcement of the regulations has led to restitution payments for many providers. However, issues such as clean claims, underpayment, discrepancies in payment dates, and self-funded claims continue to present challenges.

75 FR 16911 - Proposed Information Collection (Certificate of Delivery of Advance Payment and Enrollment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... (Certificate of Delivery of Advance Payment and Enrollment) Activity: Comment Request AGENCY: Veterans Benefits... to authorize advance payment of educational assistance benefits. DATES: Written comments and...: Submit written comments on the collection of information through Federal Docket Management System (FDMS...

78 FR 13159 - Proposed Information Collection (Certificate of Delivery of Advance Payment and Enrollment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-26

... (Certificate of Delivery of Advance Payment and Enrollment) Activity: Comment Request AGENCY: Veterans Benefits... to authorize advance payment of educational assistance benefits. DATES: Written comments and.... ADDRESSES: Submit written comments on the collection of information through Federal Docket Management System...

25 CFR 163.23 - Advance payment for timber products.

Code of Federal Regulations, 2010 CFR

2010-04-01

... otherwise authorized by the Secretary, and except in the case of lump sum (predetermined volume) sales, contracts for the sale of timber from allotted, trust or restricted Indian forest land shall provide for an... advance deposits and advance payments previously applied against timber cut from each ownership in a sale...

23 CFR 190.7 - Processing of claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Processing of claims. 190.7 Section 190.7 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES INCENTIVE PAYMENTS FOR CONTROLLING OUTDOOR ADVERTISING ON THE INTERSTATE SYSTEM § 190.7 Processing of claims. Audited and approved PR...

23 CFR 190.7 - Processing of claims.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Processing of claims. 190.7 Section 190.7 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES INCENTIVE PAYMENTS FOR CONTROLLING OUTDOOR ADVERTISING ON THE INTERSTATE SYSTEM § 190.7 Processing of claims. Audited and approved PR...

23 CFR 190.7 - Processing of claims.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Processing of claims. 190.7 Section 190.7 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES INCENTIVE PAYMENTS FOR CONTROLLING OUTDOOR ADVERTISING ON THE INTERSTATE SYSTEM § 190.7 Processing of claims. Audited and approved PR...

23 CFR 190.7 - Processing of claims.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Processing of claims. 190.7 Section 190.7 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES INCENTIVE PAYMENTS FOR CONTROLLING OUTDOOR ADVERTISING ON THE INTERSTATE SYSTEM § 190.7 Processing of claims. Audited and approved PR...

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2010 CFR

2010-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2012 CFR

2012-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2011 CFR

2011-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2014 CFR

2014-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2013 CFR

2013-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

Advanced diagnostic imaging in privately insured patients: recent trends in utilization and payments.

PubMed

Horný, Michal; Burgess, James F; Horwitt, Jedediah; Cohen, Alan B

2014-07-01

Recent studies have reported that the rate of growth in utilization of noninvasive diagnostic imaging has slowed, with a concomitant reduction in total payments to providers in the Medicare Part B fee-for-service population. Utilization and payment growth trends in commercially insured populations, however, are not as well understood. We used the Truven Health Analytics MarketScan® Commercial Claims and Encounters database containing more than 29 million individuals to investigate commercially insured population trends in utilization of and payments for CT, MRI, PET, and ultrasound procedures in the years 2007-2011. We found that imaging use--after a brief downturn in 2010--rose again in 2011, coupled with substantial increases in adjusted payments for all four imaging modalities, raising concerns about future efforts to stem growth in imaging use and associated spending. Copyright © 2014 American College of Radiology. All rights reserved.

48 CFR 970.5232-2 - Payments and advances.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Solicitation Provisions and Contract Clauses for Management and Operating Contracts 970.5232-2 Payments and advances. As prescribed in 970.3270(a... Contractor's rights to any refunds, rebates, allowances, accounts receivable, collections accruing to the...

48 CFR 970.5232-2 - Payments and advances.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Solicitation Provisions and Contract Clauses for Management and Operating Contracts 970.5232-2 Payments and advances. As prescribed in 970.3270(a... Contractor's rights to any refunds, rebates, allowances, accounts receivable, collections accruing to the...

48 CFR 970.5232-2 - Payments and advances.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Solicitation Provisions and Contract Clauses for Management and Operating Contracts 970.5232-2 Payments and advances. As prescribed in 48 CFR 970... Contractor's rights to any refunds, rebates, allowances, accounts receivable, collections accruing to the...

48 CFR 970.5232-2 - Payments and advances.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Solicitation Provisions and Contract Clauses for Management and Operating Contracts 970.5232-2 Payments and advances. As prescribed in 970.3270(a... Contractor's rights to any refunds, rebates, allowances, accounts receivable, collections accruing to the...

48 CFR 970.5232-2 - Payments and advances.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Solicitation Provisions and Contract Clauses for Management and Operating Contracts 970.5232-2 Payments and advances. As prescribed in 970.3270(a... Contractor's rights to any refunds, rebates, allowances, accounts receivable, collections accruing to the...

Clinical negligence claims in pediatric surgery in England: pattern and trends.

PubMed

Thyoka, Mandela

2015-02-01

We hypothesized that there has been an increase in the number of successful litigation claims in pediatric surgery in England. Our aim was to report the incidence, causes, and costs of clinical negligence claims against the National Health Service (NHS) in relation to pediatric surgery. We queried the NHS Litigation Authority (NHSLA) on litigation claims among children undergoing pediatric surgery in England (2004-2012). We decided a priori to only examine closed cases (decision and payment made). Data included year of claim, year of payment of claim, payment per claim, paid-to-closed ratio, and severity of outcome of clinical incident. Out of 112 clinical negligence claims in pediatric surgery, 93 (83%) were finalized-73 (65%) were settled and damages paid to the claimant and 20 (18%) were closed with no payment, and 19 (17%) remain open. The median payment was £13,537 (600-500,000) and median total cost borne by NHSLA was £31,445 (600-730,202). Claims were lodged at a median interval of 2 (0-13) years from time of occurrence with 55 (75%) cases being settled within the 3 years of being received. The commonest reasons for claims were postoperative complications (n=20, 28%), delayed treatment (n=16, 22%), and/or diagnosis (n=14, 19%). Out of 73, 17 (23%) closed claims resulted in case fatality. Conclusion: Two-thirds of all claims in pediatric surgery resulted in payment to claimant, and the commonest reasons for claims were postoperative complications, delayed treatment, and/or diagnosis. Nearly a quarter of successful claims were in cases where negligence resulted in case fatality. Pediatric surgeons should be aware of common diagnostic and treatment shortfalls as high-risk areas of increased susceptibility to clinical negligence claims. Georg Thieme Verlag KG Stuttgart · New York.

76 FR 68011 - Medicare Program; Advanced Payment Model

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

..., coordinated care and generate cost savings. The Advance Payment Model will test whether and how pre-paying a..., Medicaid, and Children's Health Insurance Program (CHIP) beneficiaries. One potential mechanism for achieving this goal is for CMS to partner with groups of health care providers of services and suppliers...

28 CFR 32.36 - Payment and repayment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Payment and repayment. 32.36 Section 32.36 Judicial Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS Educational Assistance Benefit Claims § 32.36 Payment and repayment. (a...

25 CFR 227.16 - Crediting advance annual payments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Crediting advance annual payments. 227.16 Section 227.16 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF CERTAIN LANDS IN WIND RIVER INDIAN RESERVATION, WYOMING, FOR OIL AND GAS MINING Rents and Royalties § 227.16...

25 CFR 227.16 - Crediting advance annual payments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Crediting advance annual payments. 227.16 Section 227.16 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF CERTAIN LANDS IN WIND RIVER INDIAN RESERVATION, WYOMING, FOR OIL AND GAS MINING Rents and Royalties § 227.16...

25 CFR 227.16 - Crediting advance annual payments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Crediting advance annual payments. 227.16 Section 227.16 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF CERTAIN LANDS IN WIND RIVER INDIAN RESERVATION, WYOMING, FOR OIL AND GAS MINING Rents and Royalties § 227.16...

25 CFR 227.16 - Crediting advance annual payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Crediting advance annual payments. 227.16 Section 227.16 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF CERTAIN LANDS IN WIND RIVER INDIAN RESERVATION, WYOMING, FOR OIL AND GAS MINING Rents and Royalties § 227.16...

25 CFR 227.16 - Crediting advance annual payments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Crediting advance annual payments. 227.16 Section 227.16 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF CERTAIN LANDS IN WIND RIVER INDIAN RESERVATION, WYOMING, FOR OIL AND GAS MINING Rents and Royalties § 227.16...

Nature of Medical Malpractice Claims Against Radiation Oncologists.

PubMed

Marshall, Deborah; Tringale, Kathryn; Connor, Michael; Punglia, Rinaa; Recht, Abram; Hattangadi-Gluth, Jona

2017-05-01

To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression. There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38 million in indemnity payments. The most common alleged errors included "improper performance" (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity), "errors in diagnosis" (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity), and "no medical misadventure" (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. "Improper performance" was the primary alleged error associated with injury resulting in death. Compared with claims involving death, major temporary injury (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.29-5.85, P=.009), significant permanent injury (OR 3.1, 95% CI 1.48-6.46, P=.003), and major permanent injury (OR 5.5, 95% CI 1.89-16.15, P=.002) had a higher likelihood of a claim resulting in indemnity payment. Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims against radiation oncologists may help direct efforts to improve quality of care

Nature of Medical Malpractice Claims Against Radiation Oncologists

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marshall, Deborah; Tringale, Kathryn; Connor, Michael

Purpose: To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. Methods and Materials: Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression. Results: There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38more » million in indemnity payments. The most common alleged errors included “improper performance” (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity), “errors in diagnosis” (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity), and “no medical misadventure” (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. “Improper performance” was the primary alleged error associated with injury resulting in death. Compared with claims involving death, major temporary injury (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.29-5.85, P=.009), significant permanent injury (OR 3.1, 95% CI 1.48-6.46, P=.003), and major permanent injury (OR 5.5, 95% CI 1.89-16.15, P=.002) had a higher likelihood of a claim resulting in indemnity payment. Conclusions: Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims

Medical Malpractice Claims in Radiation Oncology: A Population-Based Study 1985-2012

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marshall, Deborah C.; Punglia, Rinaa S.; Fox, Dov

Purpose: The purpose of this study was to determine trends in radiation oncology malpractice claims and expenses during the last 28 years and to compare radiation oncology malpractice claims to those of other specialties. Methods and Materials: We performed a retrospective analysis of closed malpractice claims filed from 1985 to 2012, collected by a nationwide medical liability insurance trade association. We analyzed characteristics and trends among closed claims, indemnity payments (payments to plaintiff), and litigation expenses. We also compared radiation oncology malpractice claims to those of 21 other medical specialties. Time series dollar amounts were adjusted for inflation (2012 was themore » index year). Results: There were 1517 closed claims involving radiation oncology, of which 342 (22.5%) were paid. Average and median indemnity payments were $276,792 and $122,500, respectively, ranking fifth and eighth, respectively, among the 22 specialty groups. Linear regression modeling of time trends showed decreasing total numbers of claims (β = −1.96 annually, P=.003), increasing average litigation expenses paid (β = +$1472 annually, P≤.001), and no significant changes in average indemnity payments (β = −$681, P=.89). Conclusions: Medical professional liability claims filed against radiation oncologists are not common and have declined in recent years. However, indemnity payments in radiation oncology are large relative to those of many other specialties. In recent years, the average indemnity payment has been stable, whereas litigation expenses have increased.« less

12 CFR 608.806 - Demand for payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Demand for payment. 608.806 Section 608.806 Banks and Banking FARM CREDIT ADMINISTRATION ADMINISTRATIVE PROVISIONS COLLECTION OF CLAIMS OWED THE UNITED STATES Administrative Collection of Claims § 608.806 Demand for payment. (a) A total of three...

12 CFR 1408.6 - Demand for payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Demand for payment. 1408.6 Section 1408.6 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION COLLECTION OF CLAIMS OWED THE UNITED STATES Administrative Collection of Claims § 1408.6 Demand for payment. (a) A total of three progressively stronger...

37 CFR 360.25 - Copies of claims.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 360.25 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital Audio... claim to digital audio recording devices and media royalty payments. ...

37 CFR 360.25 - Copies of claims.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 360.25 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital Audio... claim to digital audio recording devices and media royalty payments. ...

37 CFR 360.25 - Copies of claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 360.25 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital Audio... claim to digital audio recording devices and media royalty payments. ...

37 CFR 360.25 - Copies of claims.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 360.25 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital Audio... claim to digital audio recording devices and media royalty payments. ...

37 CFR 360.25 - Copies of claims.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section 360.25 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital Audio... claim to digital audio recording devices and media royalty payments. ...

38 CFR 17.127 - Date of filing claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... filing claims. The date of filing any claim for payment or reimbursement of the expenses of medical care... any preceding telephone call, telegram, or other communication constituting an informal claim. [39 FR...

75 FR 20085 - Subpart B-Advanced Biofuel Payment Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... biofuels industry is very capital intensive, the Agency is proposing multi-year contracts to enable advanced biofuels producers the assurance of a multi-year revenue stream. This approach is consistent with the goal of creating a stable industry. Finally, the Agency is proposing a two- tiered payment...

45 CFR 504.1 - Claim defined.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Regulations Relating to Public Welfare (Continued) FOREIGN CLAIMS SETTLEMENT COMMISSION OF THE UNITED STATES, DEPARTMENT OF JUSTICE RECEIPT, ADMINISTRATION, AND PAYMENT OF CLAIMS UNDER TITLE I OF THE WAR CLAIMS ACT OF... military servicemen held as prisoners of war by forces hostile to the United States. (b) A properly...

45 CFR 504.1 - Claim defined.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Regulations Relating to Public Welfare (Continued) FOREIGN CLAIMS SETTLEMENT COMMISSION OF THE UNITED STATES, DEPARTMENT OF JUSTICE RECEIPT, ADMINISTRATION, AND PAYMENT OF CLAIMS UNDER TITLE I OF THE WAR CLAIMS ACT OF... military servicemen held as prisoners of war by forces hostile to the United States. (b) A properly...

45 CFR 504.1 - Claim defined.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Regulations Relating to Public Welfare (Continued) FOREIGN CLAIMS SETTLEMENT COMMISSION OF THE UNITED STATES, DEPARTMENT OF JUSTICE RECEIPT, ADMINISTRATION, AND PAYMENT OF CLAIMS UNDER TITLE I OF THE WAR CLAIMS ACT OF... military servicemen held as prisoners of war by forces hostile to the United States. (b) A properly...

45 CFR 504.1 - Claim defined.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Regulations Relating to Public Welfare (Continued) FOREIGN CLAIMS SETTLEMENT COMMISSION OF THE UNITED STATES, DEPARTMENT OF JUSTICE RECEIPT, ADMINISTRATION, AND PAYMENT OF CLAIMS UNDER TITLE I OF THE WAR CLAIMS ACT OF... military servicemen held as prisoners of war by forces hostile to the United States. (b) A properly...

Can administrative claim file review be used to gather physical therapy, occupational therapy, and psychology payment data and functional independence measure scores? Implications for rehabilitation providers in the private health sector.

PubMed

Riis, Viivi; Jaglal, Susan; Boschen, Kathryn; Walker, Jan; Verrier, Molly

2011-01-01

Rehabilitation costs for spinal-cord injury (SCI) are increasingly borne by Canada's private health system. Because of poor outcomes, payers are questioning the value of their expenditures, but there is a paucity of data informing analysis of rehabilitation costs and outcomes. This study evaluated the feasibility of using administrative claim file review to extract rehabilitation payment data and functional status for a sample of persons with work-related SCI. Researchers reviewed 28 administrative e-claim files for persons who sustained a work-related SCI between 1996 and 2000. Payment data were extracted for physical therapy (PT), occupational therapy (OT), and psychology services. Functional Independence Measure (FIM) scores were targeted as a surrogate measure for functional outcome. Feasibility was tested using an existing approach for evaluating health services data. The process of administrative e-claim file review was not practical for extraction of the targeted data. While administrative claim files contain some rehabilitation payment and outcome data, in their present form the data are not suitable to inform rehabilitation services research. A new strategy to standardize collection, recording, and sharing of data in the rehabilitation industry should be explored as a means of promoting best practices.

28 CFR 79.75 - Procedures for payment of claims.

Code of Federal Regulations, 2011 CFR

2011-07-01

... reimbursement for burial expenses; (v) Loans or loan guarantees; (vi) Education benefits and payments; (vii) Vocational rehabilitation benefits and payments; (viii) Medical, hospital, and dental benefits; or (ix...

10 CFR 1014.10 - Action on approved claims.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Action on approved claims. 1014.10 Section 1014.10 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ADMINISTRATIVE CLAIMS UNDER FEDERAL TORT CLAIMS ACT § 1014.10 Action on approved claims. (a) Payment of any approved claim shall not be made unless the claimant...

10 CFR 1014.10 - Action on approved claims.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Action on approved claims. 1014.10 Section 1014.10 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ADMINISTRATIVE CLAIMS UNDER FEDERAL TORT CLAIMS ACT § 1014.10 Action on approved claims. (a) Payment of any approved claim shall not be made unless the claimant...

22 CFR 304.12 - Action on approved claim.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Action on approved claim. 304.12 Section 304.12 Foreign Relations PEACE CORPS CLAIMS AGAINST GOVERNMENT UNDER FEDERAL TORT CLAIMS ACT Procedures § 304.12 Action on approved claim. (a) Payment of a claim approved under this subpart is contingent on claimant's...

22 CFR 304.12 - Action on approved claim.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Action on approved claim. 304.12 Section 304.12 Foreign Relations PEACE CORPS CLAIMS AGAINST GOVERNMENT UNDER FEDERAL TORT CLAIMS ACT Procedures § 304.12 Action on approved claim. (a) Payment of a claim approved under this subpart is contingent on claimant's...

42 CFR 424.80 - Prohibition of reassignment of claims by suppliers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM CONDITIONS FOR MEDICARE PAYMENT Limitations on Assignment and Reassignment of Claims § 424.80 Prohibition of reassignment of claims by suppliers. (a) Basic... the basic rule—(1) Payment to employer. Medicare may pay the supplier's employer if the supplier is...

28 CFR 94.41 - Interim emergency payment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Interim emergency payment. 94.41 Section 94.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Payment of Claims § 94.41 Interim emergency payment...

28 CFR 94.41 - Interim emergency payment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Interim emergency payment. 94.41 Section 94.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Payment of Claims § 94.41 Interim emergency payment...

28 CFR 94.41 - Interim emergency payment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Interim emergency payment. 94.41 Section 94.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Payment of Claims § 94.41 Interim emergency payment...

28 CFR 94.41 - Interim emergency payment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Interim emergency payment. 94.41 Section 94.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Payment of Claims § 94.41 Interim emergency payment...

28 CFR 94.41 - Interim emergency payment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Interim emergency payment. 94.41 Section 94.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Payment of Claims § 94.41 Interim emergency payment...

7 CFR 4288.131 - Payment provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General Provisions Payment Provisions § 4288.131 Payment provisions. Payments to advanced biofuel producers for eligible advanced biofuel production will be determined in accordance with the provisions of...

42 CFR 447.45 - Timely claims payment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... implement an automated claims processing and information retrieval system. (2) The agency's request for a... additional information from the provider of the service or from a third party. It includes a claim with...

42 CFR 447.45 - Timely claims payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... implement an automated claims processing and information retrieval system. (2) The agency's request for a... additional information from the provider of the service or from a third party. It includes a claim with...

42 CFR 447.45 - Timely claims payment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... implement an automated claims processing and information retrieval system. (2) The agency's request for a... additional information from the provider of the service or from a third party. It includes a claim with...

42 CFR 447.45 - Timely claims payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... implement an automated claims processing and information retrieval system. (2) The agency's request for a... additional information from the provider of the service or from a third party. It includes a claim with...

Compliance with prompt payment legislation: the initial experiences of New Jersey radiologists.

PubMed

Swayne, Lawrence C; Fask, Alan; Crewson, Philip E; Stelletell, Helen D; Fanburg, John D; Williams, Gary

2002-07-01

Prompt payment has emerged as a dominant issue in managed care reform, with 47 states passing laws or regulations requiring prompt remuneration for medical services. The New Jersey Prompt-Pay Act, effective on December 28, 1999, requires payment within 30 days of electronic submission and within 40 days for nonelectronic submission. This study was undertaken to assess compliance with the New Jersey Prompt-Pay Act for radiology claims submitted 1 and 5 months after implementation (7-11 months after passage of the statute). A retrospective prompt payment analysis was undertaken of all claims submitted in February and June 2000 to six major payers by a common third-party billing company on behalf of 11 radiology practices of various sizes, settings, and locations in New Jersey. A total of 33,537 claims were assigned to one of six time periods on the basis of timeliness of payment: less than or equal to 30 days, 31-40 days, 41-50 days, 51-60 days, 61-90 days, and greater than 90 days or a separate unpaid category after 170 days had elapsed. A detailed analysis of 3156 claims from one practice was performed to estimate a clean claims submission rate. The overall percentage of claims paid within 40 days was 70%. After 170 days, the overall percentage of paid claims was 93%. The annualized interest lost on delayed payments was $23,939 for the practice analyzed. Prompt payment for radiology services remains an elusive goal in New Jersey, despite passage and implementation of prompt payment legislation.

42 CFR 431.972 - Claims sampling procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Claims sampling procedures. 431.972 Section 431.972 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe...

42 CFR 431.972 - Claims sampling procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Claims sampling procedures. 431.972 Section 431.972 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe...

Medical malpractice in urology, 1985 to 2004: 469 consecutive cases closed with indemnity payment.

PubMed

Perrotti, Michael; Badger, William; Prader, Susan; Moran, Michael E

2006-11-01

Malpractice premiums have increased by up to 57% for urologists in the last 3 years, for which the reasons are not clearly reported. We sought to better understand factors contributing to the current medical malpractice crisis in urology. Working with the Medical Liability Mutual Insurance Company of New York State we evaluated malpractice claims in urology that were closed with indemnity payment between 1985 and 2004. Individual claims were assessed for the purported negligent act, the procedure when applicable and the expense incurred. We also evaluated the impact of new technologies, eg laparoscopic nephrectomy, on reported claims. A total of 469 urology malpractice claims were closed with indemnity payment during the period evaluated for a total loss indemnity of Dollars 99,335,431. The number of files closed with indemnity payment yearly remained relatively constant at an average of 22 claims. The average indemnity payment increased each year and after correcting for inflation a 191% increase was observed for the period evaluated. The greatest number of claims was related to postoperative events (total of 101), followed by intraoperative events (96), failure to diagnose a given condition (60), medication administration error (21) and a foreign body left following surgery (20). In the area of new technologies laparoscopic surgery accounted for 4 claims and transurethral needle ablation accounted for 1. Vasectomy accounted for 8 claims. In the current study surgical procedures were the greatest generator of claims with the most common being oncological. Emerging and new technologies, eg laparoscopy and robotics, did not account for the increase in indemnity payments observed to date. Only further investigation will determine whether this is secondary to a lag time in the closure of suits related to these emerging technologies or to a lack of such suits. The actual number of claims closed with indemnity payment yearly remained relatively constant. However, the

The effect of threshold amounts for reporting malpractice payments to the National Practitioner Data Bank: analysis using the closed claims data base of the Office of the Assistant Secretary of Defense (Health Affairs).

PubMed

Metter, E J; Granville, R L; Kussman, M J

1997-04-01

The study determines the extent to which payment thresholds for reporting malpractice claims to the National Practitioner Data Bank identifies substandard health care delivery in the Department of Defense. Relevant data were available on 2,291 of 2,576 medical malpractice claims reported to the closed medical malpractice case data base of the Office of the Assistant Secretary of Defense (Health Affairs). Amount paid was analyzed as a diagnostic test using standard of care assessment from each military Surgeon General office as the criterion. Using different paid threshold amounts per claim as a positive test, the sensitivity of identifying substandard care declined from 0.69 for all paid cases to 0.41 for claims over $40,000. Specificity increased from 0.75 for all paid claims to 0.89 for claims over $40,000. Positive and negative predictive values and likelihood ratio were similar at all thresholds. Malpractice case payment was of limited value for identifying substandard medical practice. All paid claims missed about 30% of substandard care, and reported about 25% of acceptable medical practice.

12 CFR 650.50 - Payment of claims.

Code of Federal Regulations, 2010 CFR

2010-01-01

... other equities in accordance with the priorities for impairment set forth in section 8.4(e)(3) of the... claim of a lesser priority. If there are insufficient funds to pay all claims in a class in full...

31 CFR 360.29 - Adjudication of claims.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Adjudication of claims. 360.29 Section 360.29 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... the ordinary course of business. (b) Claims filed 10 years after payment. Any claim filed 10 years or...

31 CFR 360.29 - Adjudication of claims.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Adjudication of claims. 360.29 Section 360.29 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... maintained in the ordinary course of business. (b) Claims filed 10 years after payment. Any claim filed 10...

31 CFR 360.29 - Adjudication of claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Adjudication of claims. 360.29 Section 360.29 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... the ordinary course of business. (b) Claims filed 10 years after payment. Any claim filed 10 years or...

Is Payment a Benefit?

PubMed Central

Wertheimer, Alan

2011-01-01

What I call “the standard view” claims that IRBs should not regard financial payment as a benefit to subjects for the purpose of risk/benefit assessment. Although the standard view is universally accepted, there is little defense of that view in the canonical documents of research ethics or the scholarly literature. This article claims that insofar as IRBs should be concerned with the interests and autonomy of research subjects, they should reject the standard view and adopt “the incorporation view.” The incorporation view is more consistent with the underlying soft-paternalist justification for risk-benefit assessment and demonstrates respect for the autonomy of prospective subjects. Adoption of the standard view precludes protocols that advance the interests of subjects, investigators, and society. After considering several objections to the argument, I consider several arguments for the standard view that do not appeal to the interests and autonomy of research subjects. PMID:21726261

48 CFR 33.208 - Interest on claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... otherwise would be due, if that date is later, until the date of payment. (b) Simple interest on claims... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Interest on claims. 33.208... REQUIREMENTS PROTESTS, DISPUTES, AND APPEALS Disputes and Appeals 33.208 Interest on claims. (a) The Government...

28 CFR 32.6 - Payment and repayment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Payment and repayment. 32.6 Section 32.6 Judicial Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS General Provisions § 32.6 Payment and repayment. (a) No payment shall be made to...

28 CFR 32.6 - Payment and repayment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Payment and repayment. 32.6 Section 32.6 Judicial Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS General Provisions § 32.6 Payment and repayment. (a) No payment shall be made to...

7 CFR 4288.130 - Payment applications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... process and procedures the Agency will use to make payments to eligible advanced biofuel producers. In order to receive payments under this Program, eligible advanced biofuel producers with valid contracts...

7 CFR 4288.130 - Payment applications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... process and procedures the Agency will use to make payments to eligible advanced biofuel producers. In order to receive payments under this Program, eligible advanced biofuel producers with valid contracts...

7 CFR 4288.131 - Payment provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General Provisions § 4288.131 Payment provisions. Payments to advanced biofuel producers for eligible advanced biofuel production will be determined in accordance with the provisions of this section. (a) Types...

7 CFR 4288.130 - Payment applications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... identify the process and procedures the Agency will use to make payments to eligible advanced biofuel producers. In order to receive payments under this Program, eligible advanced biofuel producers with valid...

7 CFR 4288.131 - Payment provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General Provisions § 4288.131 Payment provisions. Payments to advanced biofuel producers for eligible advanced biofuel production will be determined in accordance with the provisions of this section. (a) Types...

32 CFR 1659.1 - Claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... from the date on which the expenses were incurred. (e) No such claim shall be allowed in case it is determined that the cause of injury, illness, or death was due to negligence or misconduct of the registrant... Service Act in any one case. (g) Payment of such claims when allowed shall be made only: (1) Directly to...

20 CFR 362.3 - Who may file a claim.

Code of Federal Regulations, 2010 CFR

2010-04-01

...' PERSONAL PROPERTY CLAIMS § 362.3 Who may file a claim. A claim may be filed by an employee, by his spouse... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Who may file a claim. 362.3 Section 362.3... or sister, or both, may file the claim and be entitled to payment in that order of priority. ...

20 CFR 362.3 - Who may file a claim.

Code of Federal Regulations, 2011 CFR

2011-04-01

...' PERSONAL PROPERTY CLAIMS § 362.3 Who may file a claim. A claim may be filed by an employee, by his spouse... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Who may file a claim. 362.3 Section 362.3... or sister, or both, may file the claim and be entitled to payment in that order of priority. ...

7 CFR 623.22 - Filing of false claims.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... If it is determined by NRCS that any participant has knowingly supplied false information or has... information or false claims include claims for payment for practices which do not meet the specifications of... 7 Agriculture 6 2010-01-01 2010-01-01 false Filing of false claims. 623.22 Section 623.22...

28 CFR 104.51 - Payments to eligible individuals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Payments to eligible individuals. 104.51 Section 104.51 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) SEPTEMBER 11TH VICTIM COMPENSATION FUND OF 2001 Payment of Claims § 104.51 Payments to eligible individuals. Not later than 20 days...

20 CFR 404.2108 - Requirements for payment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 404.2115; (d) The VR...

20 CFR 416.2208 - Requirements for payment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 416.2215; (d) The VR...

20 CFR 416.2208 - Requirements for payment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 416.2215; (d) The VR...

20 CFR 404.2108 - Requirements for payment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 404.2115; (d) The VR...

20 CFR 416.2208 - Requirements for payment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 416.2215; (d) The VR...

20 CFR 416.2208 - Requirements for payment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 416.2215; (d) The VR...

20 CFR 404.2108 - Requirements for payment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 404.2115; (d) The VR...

20 CFR 404.2108 - Requirements for payment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 404.2115; (d) The VR...

20 CFR 404.2108 - Requirements for payment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 404.2115; (d) The VR...

20 CFR 416.2208 - Requirements for payment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Requirements for payment. (a) The State VR agency or alternate participant must file a claim for payment in... provided; (2) When the service was provided; and (3) The cost of the service; (c) The VR services for which payment is being requested must have been provided during the period specified in § 416.2215; (d) The VR...

49 CFR 89.23 - Interest, late payment penalties, and collection charges.

Code of Federal Regulations, 2010 CFR

2010-10-01

... received. Interest shall be calculated only on the principal of the debt (simple interest). The rate of... 49 Transportation 1 2010-10-01 2010-10-01 false Interest, late payment penalties, and collection... THE FEDERAL CLAIMS COLLECTION ACT Collection of Claims § 89.23 Interest, late payment penalties, and...

37 CFR 360.22 - Form and content of claims.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... 360.22 Section 360.22 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital...) Each claim to digital audio recording devices and media royalty payments (DART) shall be furnished on a...

37 CFR 360.22 - Form and content of claims.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... 360.22 Section 360.22 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital...) Each claim to digital audio recording devices and media royalty payments (DART) shall be furnished on a...

37 CFR 360.22 - Form and content of claims.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... 360.22 Section 360.22 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital...) Each claim to digital audio recording devices and media royalty payments (DART) shall be furnished on a...

37 CFR 360.22 - Form and content of claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... 360.22 Section 360.22 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital...) Each claim to digital audio recording devices and media royalty payments (DART) shall be furnished on a...

37 CFR 360.22 - Form and content of claims.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... 360.22 Section 360.22 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital...) Each claim to digital audio recording devices and media royalty payments (DART) shall be furnished on a...

12 CFR 627.2750 - Priority of claims-banks.

Code of Federal Regulations, 2012 CFR

2012-01-01

... accordance with priorities of applicable Federal or State law. (g) All claims of holders of bonds issued by... claims of holders of consolidated and System-wide bonds and all claims of the other Farm Credit banks arising from their payments on consolidated and System-wide bonds pursuant to 12 U.S.C. 2155 or pursuant...

12 CFR 627.2750 - Priority of claims-banks.

Code of Federal Regulations, 2013 CFR

2013-01-01

... accordance with priorities of applicable Federal or State law. (g) All claims of holders of bonds issued by... claims of holders of consolidated and System-wide bonds and all claims of the other Farm Credit banks arising from their payments on consolidated and System-wide bonds pursuant to 12 U.S.C. 2155 or pursuant...

12 CFR 627.2750 - Priority of claims-banks.

Code of Federal Regulations, 2014 CFR

2014-01-01

... accordance with priorities of applicable Federal or State law. (g) All claims of holders of bonds issued by... claims of holders of consolidated and System-wide bonds and all claims of the other Farm Credit banks arising from their payments on consolidated and System-wide bonds pursuant to 12 U.S.C. 2155 or pursuant...

Malpractice in distal radius fracture management: an analysis of closed claims.

PubMed

DeNoble, Peter H; Marshall, Astrid C; Barron, O Alton; Catalano, Louis W; Glickel, Steven Z

2014-08-01

Distal radius fractures comprise the majority of hand- and wrist-related malpractice claims. We hypothesized that a majority of lawsuits would be for malunions resulting from nonsurgical treatment. Additional goals of this study were to quantify costs associated with claims, determine independent risk factors for making an indemnity payment, and illustrate trends over time. Seventy closed malpractice claims filed for alleged negligent treatment of distal radius fractures by orthopedic surgeons insured by the largest medical professional liability insurer in New York State (NYS) from 1981 to 2005 were reviewed. We separately reviewed defendants' personal closed malpractice claim histories from 1975 to 2011. Overall incidence of malpractice claims among distal radius fractures treated in NYS was calculated using the NYS Statewide Planning and Research Cooperative System database and the 2008 American Academy of Orthopedic Surgeons census data. The overall incidence of malpractice claims for distal radius fracture management was low. Malunion was the most common complaint across claims regardless of treatment type. Claims for surgically treated fractures increased over time. A majority of claims documented poor doctor-patient relationships. Male plaintiffs in this group were significantly older than males treated for distal radius fractures in NYS. Most defendants had a history of multiple malpractice suits, all were male, and only a small percentage were fellowship-trained in hand surgery. Defendants lacking American Board of Orthopedic Surgery certification were significantly more likely to make indemnity payments. Thirty-eight of 70 cases resulted in an indemnity payment. Malunion and poor doctor-patient relationships are the major features of malpractice litigation involving distal radius fracture management. Older defendant age and lack of American Board of Orthopedic Surgery certification increase the likelihood of making an indemnity payment. Economic and

Obesity and trends in malpractice claims for physicians and surgeons.

PubMed

Weber, Cynthia E; Talbot, Lindsay J; Geller, Justin M; Kuo, Marissa C; Wai, Philip Y; Kuo, Paul C

2013-08-01

The increasing prevalence of obesity has altered the practice of medicine and surgery, with the emergence of new operations and medications. We hypothesized that the landscape of medical malpractice claims has also changed. We queried the Physician Insurers Association of American database for 1990 through 1999 and 2000 through 2009 for cases corresponding to International Classification of Diseases, 9th edition, codes for obesity. We extracted adjudicatory outcome, closed and paid claims data, indemnity payments, primary alleged error codes, National Association of Insurance Commissioners severity of injury class, procedural codes, and medical specialty data. A total of 411 obesity claims were filed from 1990 to 1999 and 1,591 obesity claims were filed from 2000 to 2009. General surgery was the specialty with the greatest number of obesity claims from 1990 to 1999 and was second to family practice for 2000 to 2009. Although the percentage of paid general surgery obesity claims has decreased significantly from 69% in 1990-1999 to 36% in 2000-2009, the mean indemnity payments have increased substantially ($94,000 to $368,000). Recently, the percentage of paid general surgery obesity claims has significantly decreased; however, individual and total indemnity payments have increased. Obesity continues to impact general surgery malpractice substantially. Efforts to manage this component of physician and hospital practices must continue. Copyright © 2013 Mosby, Inc. All rights reserved.

Decreasing Malpractice Claims by Reducing Preventable Perinatal Harm.

PubMed

Riley, William; Meredith, Les W; Price, Rebecca; Miller, Kristi K; Begun, James W; McCullough, Mac; Davis, Stanley

2016-12-01

To evaluate the association of improved patient safety practices with medical malpractice claims and costs in the perinatal units of acute care hospitals. Malpractice and harm data from participating hospitals; litigation records and medical malpractice claims data from American Excess Insurance Exchange, RRG, whose data are managed by Premier Insurance Management Services, Inc. (owned by Premier Inc., a health care improvement company). A quasi-experimental prospective design to compare baseline and postintervention data. Statistical significance tests for differences were performed using chi-square, Wilcoxon signed-rank test, and t-test. Claims data were collected and evaluated by experienced senior claims managers through on-site claim audits to evaluate claim frequency, severity, and financial information. Data were provided to the analyzing institution through confidentiality contracts. There is a significant reduction in the number of perinatal malpractice claims paid, losses paid, and indemnity payments (43.9 percent, 77.6 percent, and 84.6 percent, respectively) following interventions to improve perinatal patient safety and reduce perinatal harm. This compares with no significant reductions in the nonperinatal claims in the same hospitals during the same time period. The number of perinatal malpractice claims and dollar amount of claims payments decreased significantly in the participating hospitals, while there was no significant decrease in nonperinatal malpractice claims activity in the same hospitals. © Health Research and Educational Trust.

7 CFR 4288.134 - Refunds and interest payments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment... advanced biofuel producer who receives payments under this subpart may be required to refund such payments... General for appropriate action. (a) An eligible advanced biofuel producer receiving payments under this...

26 CFR 31.3507-1 - Advance payments of earned income credit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... credit advance payment certificate and the payroll periods for which the certificate is effective, see... amount of an employee is determined, with respect to any payroll period, on the basis of the employee's... the Commissioner of Internal Revenue and then in effect for the payroll period. See, however...

29 CFR 100.616 - Payment collection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Payment collection. 100.616 Section 100.616 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD ADMINISTRATIVE REGULATIONS Debt Collection Procedures § 100.616 Payment collection. (a) The NLRB shall make every effort to collect a claim in full...

Medicare Program; Cancellation of Advancing Care Coordination Through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model: Extreme and Uncontrollable Circumstances Policy for the Comprehensive Care for Joint Replacement Payment Model. Final rule; interim final rule with comment period.

PubMed

2017-12-01

This final rule cancels the Episode Payment Models (EPMs) and Cardiac Rehabilitation (CR) Incentive Payment Model and rescinds the regulations governing these models. It also implements certain revisions to the Comprehensive Care for Joint Replacement (CJR) model, including: Giving certain hospitals selected for participation in the CJR model a one-time option to choose whether to continue their participation in the model; technical refinements and clarifications for certain payment, reconciliation and quality provisions; and a change to increase the pool of eligible clinicians that qualify as affiliated practitioners under the Advanced Alternative Payment Model (Advanced APM) track. An interim final rule with comment period is being issued in conjunction with this final rule in order to address the need for a policy to provide some flexibility in the determination of episode costs for providers located in areas impacted by extreme and uncontrollable circumstances.

32 CFR 536.78 - Settlement authority for claims under the Military Claims Act.

Code of Federal Regulations, 2010 CFR

2010-07-01

... satisfaction of the claim. (6) Authority to further delegate payment authority is set forth in § 536.3(g)(1) of... compensation of federal employees for job-related injuries (see § 536.44), or untimely filing, TJAG or TAJAG...

32 CFR 536.78 - Settlement authority for claims under the Military Claims Act.

Code of Federal Regulations, 2011 CFR

2011-07-01

... satisfaction of the claim. (6) Authority to further delegate payment authority is set forth in § 536.3(g)(1) of... compensation of federal employees for job-related injuries (see § 536.44), or untimely filing, TJAG or TAJAG...

32 CFR 538.4 - Convertibility of military payment certificates.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Convertibility of military payment certificates. 538.4 Section 538.4 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS MILITARY PAYMENT CERTIFICATES § 538.4 Convertibility of military payment certificates. (a...

Relationship between tort claims and patient incident reports in the Veterans Health Administration

PubMed Central

Schmidek, J; Weeks, W

2005-01-01

Objective: The Veterans Health Administration's patient incident reporting system was established to obtain comprehensive data on adverse events that affect patients and to act as a harbinger for risk management. It maintains a dataset of tort claims that are made against Veterans Administration's employees acting within the scope of employment. In an effort to understand the thoroughness of reporting, we examined the relationship between tort claims and patient incident reports (PIRs). Methods: Using social security and record numbers, we matched 8260 tort claims and 32 207 PIRs from fiscal years 1993–2000. Tort claims and PIRs were considered to be related if the recorded dates of incident were within 1 month of each other. Descriptive statistics, odds ratios, and two sample t tests with unequal variances were used to determine the relationship between PIRs and tort claims. Results: 4.15% of claims had a related PIR. Claim payment (either settlement or judgment for plaintiff) was more likely when associated with a PIR (OR 3.62; 95% CI 2.87 to 4.60). Payment was most likely for medication errors (OR 8.37; 95% CI 2.05 to 73.25) and least likely for suicides (OR 0.25; 95% CI 0.11 to 0.55). Conclusions: Although few tort claims had a related PIR, if a PIR was present the tort claim was more likely to result in a payment; moreover, the payment was likely to be higher. Underreporting of patient incidents that developed into tort claims was evident. Our findings suggest that, in the Veterans Health Administration, there is a higher propensity to both report and settle PIRs with bad outcomes. PMID:15805457

Analysis of obstetrics and gynecology professional liability claims in Catalonia, Spain (1986-2010).

PubMed

Gómez-Durán, Esperanza L; Mulà-Rosías, Joan Antoni; Lailla-Vicens, Josep Maria; Benet-Travé, Josep; Arimany-Manso, Josep

2013-07-01

To identify relevant factors involved in obstetrics and gynecology (OG) professional liability claims to help archive better management of risks. Analysis of 885 OG claims opened between 1986 and 2010, with the identification of the most common events leading to a claim, the economical and juridical characteristics of the claims, as well as the relevant trends over the study period. Most claims related to obstetrics. Labor, delivery and its complications accounted for 33.1% of the claims; 12.77% related specifically to cesarean. Oncological diseases, fetus death during labor and delivery, neurologically impaired infant and histerectomy-related problems were the most frequently claimed events. Most cases ended up without an indemnity payment and 37.7% of closed files were solved by an out-of-court procedure. Average payment was higher for the obstetric procedures than for those concerning gynecology cases. The proportion of claims relating to obstetrics increased during the study period, as well as the average payment. OG is at high-risk for malpractice claims, but compensation awards are not frequent. However, particular events, such as retained foreign objects, tubal ligation, ultrasound diagnosis or neurologically impaired newborns, deserve special attention regarding medico-legal issues. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

38 CFR 1.904 - Form of payment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Claims for Money Or Property § 1.904 Form of payment. Claims may be paid in the form of money or, when a contractual basis exists, VA may demand the return of specific property or the performance of specific...

Paid malpractice claims for adverse events in inpatient and outpatient settings.

PubMed

Bishop, Tara F; Ryan, Andrew M; Ryan, Andrew K; Casalino, Lawrence P

2011-06-15

An analysis of paid malpractice claims may provide insight into the prevalence and seriousness of adverse medical events in the outpatient setting. To report and compare the number, magnitude, and type of paid malpractice claims for events in inpatient and outpatient settings. Retrospective analysis of malpractice claims paid on behalf of physicians in outpatient and inpatient settings using data from the National Practitioner Data Bank from 2005 through 2009. We evaluated trends in claims paid by setting, characteristics of paid claims, and factors associated with payment amount. Number of paid claims, mean and median payment amounts, types of errors, and outcomes of errors. In 2009, there were 10,739 malpractice claims paid on behalf of physicians. Of these paid claims, 4910 (47.6%; 95% confidence interval [CI], 46.6%-48.5%) were for events in the inpatient setting, 4448 (43.1%; 95% CI, 42.1%-44.0%) were for events in the outpatient setting, and 966 (9.4%; 95% CI, 8.8%-9.9%) involved events in both settings. The proportion of payments for events in the outpatient setting increased by a small but statistically significant amount, from 41.7% (95% CI, 40.9%-42.6%) in 2005 to 43.1% (95% CI, 42.1%-44.0%) in 2009 (P < .001 for trend across years). In the outpatient setting, the most common reason for a paid claim was diagnostic (45.9%; 95% CI, 44.4%-47.4%), whereas in the inpatient setting the most common reason was surgical (34.1%; 95% CI, 32.8%-35.4%). Major injury and death were the 2 most common outcomes in both settings. Mean payment amount for events in the inpatient setting was significantly higher than in the outpatient setting ($362,965; 95% CI, $348,192-$377,738 vs $290,111; 95% CI, $278,289-$301,934; P < .001). In 2009, the number of paid malpractice claims reported to the National Practitioner Data Bank for events in the outpatient setting was similar to the number in the inpatient setting.

7 CFR 4288.134 - Refunds and interest payments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General Provisions § 4288.134 Refunds and interest payments. An eligible advanced biofuel producer...) An eligible advanced biofuel producer receiving payments under this subpart shall become ineligible...

7 CFR 4288.134 - Refunds and interest payments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General Provisions § 4288.134 Refunds and interest payments. An eligible advanced biofuel producer...) An eligible advanced biofuel producer receiving payments under this subpart shall become ineligible...

20 CFR 410.588 - Claims of creditors.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Claims of creditors. 410.588 Section 410.588 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of Benefits § 410.588 Claims of creditors. A relative or other...

20 CFR 410.588 - Claims of creditors.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Claims of creditors. 410.588 Section 410.588 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of Benefits § 410.588 Claims of creditors. A relative or other...

13 CFR 114.108 - What if my claim is approved?

Code of Federal Regulations, 2010 CFR

2010-01-01

... agent or legal representative the forms necessary to indicate satisfaction of your claim and your acceptance of the payment. Acceptance by you, your agent or your legal representative of any award, compromise or settlement releases all your claims against the United States under the Federal Tort Claims Act...

28 CFR 32.36 - Payment and repayment.

Code of Federal Regulations, 2010 CFR

2010-07-01

....36 Judicial Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS Educational Assistance Benefit Claims § 32.36 Payment and repayment. (a... from the eligible educational institution as to the claimant's full-, three-quarter-, half-, or less...

Operating room fires: a closed claims analysis.

PubMed

Mehta, Sonya P; Bhananker, Sanjay M; Posner, Karen L; Domino, Karen B

2013-05-01

To assess patterns of injury and liability associated with operating room (OR) fires, closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1985 were reviewed. All claims related to fires in the OR were compared with nonfire-related surgical anesthesia claims. An analysis of fire-related claims was performed to identify causative factors. There were 103 OR fire claims (1.9% of 5,297 surgical claims). Electrocautery was the ignition source in 90% of fire claims. OR fire claims more frequently involved older outpatients compared with other surgical anesthesia claims (P < 0.01). Payments to patients were more often made in fire claims (P < 0.01), but payment amounts were lower (median $120,166) compared to nonfire surgical claims (median $250,000, P < 0.01). Electrocautery-induced fires (n = 93) increased over time (P < 0.01) to 4.4% claims between 2000 and 2009. Most (85%) electrocautery fires occurred during head, neck, or upper chest procedures (high-fire-risk procedures). Oxygen served as the oxidizer in 95% of electrocautery-induced OR fires (84% with open delivery system). Most electrocautery-induced fires (n = 75, 81%) occurred during monitored anesthesia care. Oxygen was administered via an open delivery system in all high-risk procedures during monitored anesthesia care. In contrast, alcohol-containing prep solutions and volatile compounds were present in only 15% of OR fires during monitored anesthesia care. Electrocautery-induced fires during monitored anesthesia care were the most common cause of OR fires claims. Recognition of the fire triad (oxidizer, fuel, and ignition source), particularly the critical role of supplemental oxygen by an open delivery system during use of the electrocautery, is crucial to prevent OR fires. Continuing education and communication among OR personnel along with fire prevention protocols in high-fire-risk procedures may reduce the occurrence of OR fires.

32 CFR 536.144 - Reopening a claim after final action by a Foreign Claims Commission.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and if appropriate, a supplemental payment made. The basis for a change in action will be stated in a... representative, will reopen action on that claim and, if the belief is substantiated, correct the action. The...

Characteristics of medical professional liability claims in patients treated by family medicine physicians.

PubMed

Flannery, Frank T; Parikh, Parul Divya; Oetgen, William J

2010-01-01

This study describes a large database of closed medical professional liability (MPL) claims involving family physicians in the United States. The purpose of this report is to provide information for practicing family physicians that will be useful in improving the quality of care, thereby reducing the incidence of patient injury and the consequent frequency of MPL claims. The Physician Insurers Association of America (PIAA) established a registry of closed MPL claims in 1985. This registry contains data describing 239,756 closed claims in the United States through 2008. The registry is maintained for educational programs that are designed to improve quality of care and reduce patient injury MPL claims. We summarized this closed claims database. Of 239,756 closed claims, 27,556 (11.5%) involved family physicians. Of these 27,556 closed claims, 8797 (31.9%) resulted in a payment, and the average payment was $164,107. In the entire registry, 29.5% of closed claims were paid, and the average payment was $209,156. The most common allegation among family medicine closed claims was diagnostic error, and the most prevalent diagnosis was acute myocardial infarction, which represented 24.1% of closed claims with diagnostic errors. Diagnostic errors related to patients with breast cancer represented the next most common condition, accounting for 21.3% of closed claims with diagnostic errors. MPL issues are common and are important to all practicing family physicians. Knowledge of the details of liability claims should assist practicing family physicians in improving quality of care, reducing patient injury, and reducing the incidence of MPL claims.

22 CFR 221.31 - Prosecution of claims.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Prosecution of claims. 221.31 Section 221.31 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEE STANDARD TERMS AND CONDITIONS Covenants § 221.31 Prosecution of claims. After payment by A.I.D. to an Applicant pursuant to § 221.21, A.I...

22 CFR 221.31 - Prosecution of claims.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Prosecution of claims. 221.31 Section 221.31 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEE STANDARD TERMS AND CONDITIONS Covenants § 221.31 Prosecution of claims. After payment by A.I.D. to an Applicant pursuant to § 221.21, A.I...

22 CFR 221.31 - Prosecution of claims.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Prosecution of claims. 221.31 Section 221.31 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEE STANDARD TERMS AND CONDITIONS Covenants § 221.31 Prosecution of claims. After payment by A.I.D. to an Applicant pursuant to § 221.21, A.I...

22 CFR 221.31 - Prosecution of claims.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Prosecution of claims. 221.31 Section 221.31 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEE STANDARD TERMS AND CONDITIONS Covenants § 221.31 Prosecution of claims. After payment by A.I.D. to an Applicant pursuant to § 221.21, A.I...

22 CFR 221.31 - Prosecution of claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Prosecution of claims. 221.31 Section 221.31 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEE STANDARD TERMS AND CONDITIONS Covenants § 221.31 Prosecution of claims. After payment by A.I.D. to an Applicant pursuant to § 221.21, A.I...

42 CFR 447.207 - Retention of payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Retention of payments. 447.207 Section 447.207 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... computable payment to ensure that the State's claimed expenditure, which serves as the basis for Federal...

Prompt payment depends on revenue-cycle diligence.

PubMed

Barber, Robert L

2002-12-01

How effectively you manage the revenue cycle is reflected in the cycle's outcome-whether you receive full and timely payment for all services billed to payers. To ensure prompt and full payment, you should: Educate your patient financial services (PFS) staff on all relevant laws and regulations regarding payment for healthcare services. Make sure your staff is well versed in all of the provisions of your payer contracts. Implement a state-of-the-art patient accounting system that is capable of producing drill-down reports of all aspects of contract performance by payer. Enforce payer compliance by maintaining complete records of dates of service, final billing dates, dates claims were mailed or electronically submitted to the payer, all actions performed by your staff regarding claims, and all communications with the payer.

7 CFR 4288.113 - Payment record requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment... for Program payments, an advanced biofuel producer must maintain records for all relevant fiscal years and fiscal year quarters for each advanced biofuel facility indicating: (a) The type of eligible...

48 CFR 252.232-7005 - Reimbursement of subcontractor advance payments-DoD pilot mentor-protege program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... subcontractor advance payments-DoD pilot mentor-protege program. 252.232-7005 Section 252.232-7005 Federal... subcontractor advance payments—DoD pilot mentor-protege program. As prescribed in 232.412-70(c), use the following clause: Reimbursement of Subcontractor Advance Payments—DoD Pilot Mentor-Protege Program (SEP 2001...

6 CFR 11.3 - Demand for payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Demand for payment. 11.3 Section 11.3 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CLAIMS § 11.3 Demand for payment. (a) Notice requirements. Generally, before DHS starts the collection actions described in this subpart, DHS...

31 CFR 250.5 - Manner of payment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Manner of payment. 250.5 Section 250.5 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE PAYMENT ON ACCOUNT OF AWARDS OF THE FOREIGN CLAIMS...

38 CFR 21.9680 - Certifications and release of payments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... approved licensing or certification test, or one who qualifies for an advance payment of the monthly...) (2) Advance payments. VA will apply the provisions of this section in making advance payments of the... allowance in advance when: (A) The eligible individual has specifically requested such a payment; (B) The...

Impact of the National Practitioner Data Bank on resolution of malpractice claims.

PubMed

Waters, Teresa M; Studdert, David M; Brennan, Troyen A; Thomas, Eric J; Almagor, Orit; Mancewicz, Martha; Budetti, Peter P

2003-01-01

Policymakers and commentators are concerned that the National Practitioner Data Bank (NPDB) has influenced malpractice litigation dynamics. This study examines whether the introduction of the NPDB changed the outcomes, process, and equity of malpractice litigation. Using pre- and post-NPDB analyses, we examine rates of unpaid claims, trials, resolution time, physician defense costs, and payments on claims with a low/high probability of negligence. We find that physicians and their insurers have been less likely to settle claims since introduction of the NPDB, especially for payments less than dollars 50,000. Because this disruption appears to have decreased the proportion of questionable claims receiving compensation, the NPDB actually may have increased overall tort system specificity.

7 CFR 1410.61 - Filing of false claims.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of false claims. If CCC determines that any participant has knowingly supplied false information or... with respect to the program year in which the false information or claim was filed and the contract may be terminated, in which case a full refund of all prior payments may be demanded. False information...

Medical Malpractice Claims Related to Cataract Surgery Complicated by Retained Lens Fragments (An American Ophthalmological Society Thesis)

PubMed Central

Kim, Judy E.; Weber, Paul; Szabo, Aniko

2012-01-01

Purpose: To review malpractice claims associated with retained lens fragments during cataract surgery to identify ways to improve patient outcomes. Methods: Retrospective, noncomparative, consecutive case series. Closed claims data related to cataract surgeries complicated by retained lens fragments (1989 through 2009) from an ophthalmic insurance carrier were reviewed. Factors associated with these claims and claims outcomes were analyzed. Results: During the 21-year period, 117 (12.5%) of 937 closed claims associated with cataract surgery were related to retained lens fragments with 108 unique cataract surgeries, 97% against cataract surgeon and 3% against retinal surgeon. Twelve (11%) of 108 claims were resolved by a trial, 30 (28%) were settled, and 66 (61%) were dismissed. The defendant prevailed in 83% of trials. Indemnity payments totaling more than $3,586,000 were made in 32 (30%) of the claims (median payment, $90,000). The difference between the preoperative visual acuity and the final visual acuity was predictive of an indemnity payment (odds ratio [OR], 2.28; P=.001) and going to a trial (OR, 2.93; P=.000). Development of corneal edema was associated with an indemnity payment (OR, 3.50; P=.037). Timing of referral and elevated intraocular pressure (IOP) were statistically significant in univariate analyses but not in multivariate analyses for a trial. Conclusions: Whereas the majority of claims were dismissed, claims associated with greater visual acuity decline, corneal edema, or elevated IOP were more likely to result in a trial or payment. Ways to reduce significant vision loss, including improved management of corneal edema and IOP, and timely referral to a subspecialist should be considered. PMID:23818737

31 CFR 900.5 - Form of payment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... payment. Claims may be paid in the form of money or, when a contractual basis exists, the Government may demand the return of specific property or the performance of specific services. ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Form of payment. 900.5 Section 900.5...

26 CFR 48.6420(a)-2 - Gasoline includible in claim.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 16 2012-04-01 2012-04-01 false Gasoline includible in claim. 48.6420(a)-2... of Special Application to Retailers and Manufacturers Taxes § 48.6420(a)-2 Gasoline includible in claim. Payment may be claimed under section 6420 only in respect of gasoline used on a farm in the...

26 CFR 48.6420(a)-2 - Gasoline includible in claim.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Gasoline includible in claim. 48.6420(a)-2... of Special Application to Retailers and Manufacturers Taxes § 48.6420(a)-2 Gasoline includible in claim. Payment may be claimed under section 6420 only in respect of gasoline used on a farm in the...

26 CFR 48.6420(a)-2 - Gasoline includible in claim.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Gasoline includible in claim. 48.6420(a)-2... of Special Application to Retailers and Manufacturers Taxes § 48.6420(a)-2 Gasoline includible in claim. Payment may be claimed under section 6420 only in respect of gasoline used on a farm in the...

26 CFR 48.6420(a)-2 - Gasoline includible in claim.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Gasoline includible in claim. 48.6420(a)-2... of Special Application to Retailers and Manufacturers Taxes § 48.6420(a)-2 Gasoline includible in claim. Payment may be claimed under section 6420 only in respect of gasoline used on a farm in the...

42 CFR 60.40 - Procedures for filing claims.

Code of Federal Regulations, 2011 CFR

2011-10-01

... must file an insurance claim on a form approved by the Secretary. The lender or holder must attach to... claim, including any payments made; and (5) A Borrower Status Form (HRSA-508), documenting each... after a loan has been determined to be in default. (ii) If a lender files suit against a defaulted...

42 CFR 60.40 - Procedures for filing claims.

Code of Federal Regulations, 2014 CFR

2014-10-01

... must file an insurance claim on a form approved by the Secretary. The lender or holder must attach to... claim, including any payments made; and (5) A Borrower Status Form (HRSA-508), documenting each... after a loan has been determined to be in default. (ii) If a lender files suit against a defaulted...

42 CFR 60.40 - Procedures for filing claims.

Code of Federal Regulations, 2012 CFR

2012-10-01

... must file an insurance claim on a form approved by the Secretary. The lender or holder must attach to... claim, including any payments made; and (5) A Borrower Status Form (HRSA-508), documenting each... after a loan has been determined to be in default. (ii) If a lender files suit against a defaulted...

42 CFR 60.40 - Procedures for filing claims.

Code of Federal Regulations, 2013 CFR

2013-10-01

... must file an insurance claim on a form approved by the Secretary. The lender or holder must attach to... claim, including any payments made; and (5) A Borrower Status Form (HRSA-508), documenting each... after a loan has been determined to be in default. (ii) If a lender files suit against a defaulted...

10 CFR 1015.105 - Form of payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DEPARTMENT OF ENERGY (GENERAL PROVISIONS) COLLECTION OF CLAIMS OWED THE UNITED STATES General § 1015.105 Form of payment. Claims may be paid in the form of money or, when a contractual basis exists, the Government may demand the return of specific property or the performance of specific services. ...

32 CFR 842.118 - Assertable claims.

Code of Federal Regulations, 2011 CFR

2011-07-01

... it merits assertion. Claims for $150 or less need not be asserted; they should be asserted only if... party offers payment and demands a release from the United States before paying damages to the injured...

32 CFR 842.118 - Assertable claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... it merits assertion. Claims for $150 or less need not be asserted; they should be asserted only if... party offers payment and demands a release from the United States before paying damages to the injured...

14 CFR 151.129 - Payments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151.129 Payments. (a) The United States' share of advance planning costs is paid in two installments unless the advance planning grant agreement provides otherwise. Upon request by sponsor, the first payment may be...

Lessons regarding the safety of orthopaedic patient care: an analysis of four hundred and sixty-four closed malpractice claims.

PubMed

Matsen, Frederick A; Stephens, Linda; Jette, Jocelyn L; Warme, Winston J; Posner, Karen L

2013-02-20

An orthopaedic malpractice claim alleges that the patient sustained a preventable iatrogenic injury. The analysis of a representative series of malpractice claims provides a unique view of alleged orthopaedic adverse events, revealing what can potentially go wrong across a spectrum of practice settings and anatomic locations. The goal of this study was to identify high-impact targets in order to institute measures to reduce claims through efforts focused on patient safety. The authors investigated 464 consecutive closed malpractice claims from the nation's largest insurer of medical liability. We analyzed the claims by anatomical site, type of care rendered, type of allegation, and payment. We calculated an "impact factor" for each claim type by dividing the percentage of total payments for each type by the percentage of total claims for that type. Our analysis revealed major concerns regarding patient safety within this series of malpractice claims. One-third of the claims alleged permanent disabling injuries, including amputations, brain damage, and major nerve damage. The highest impact allegations were failure to protect structures in the surgical field (41% of total payments to plaintiffs, 15% of all claims, impact factor of 2.7) and failure to prevent, diagnose, and/or treat complications of treatment (16% of total payments, 7% of all claims, impact factor of 2.3). Spine procedures had high impact (1.9), representing 28% of dollars paid and 15% of claims, with 45% of spine claims involving death or severe permanent injury. Failure of implant positioning was commonly alleged in hip and knee arthroplasty. In claims related to fracture care, the most common allegations were related to malunions, nonunions, dislocations, failure to protect structures in the surgical field, infection, and treatment complications. Total payment for the eighty-eight claims paid was $17,917,614 (U.S. dollars adjusted to 2009). Regarding clinical relevance, this analysis suggests risk

47 CFR 0.469 - Advance payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the requester has no history of payment. Where allowable charges are likely to exceed $250.00 and the requester has a history of prompt payment of FOIA fees the Commission may notify the requester of the... (k) (i.e., twenty business days from receipt of initial requests and twenty business days from...

77 FR 76624 - Prompt Payment Interest Rate; Contract Disputes Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

... DEPARTMENT OF THE TREASURY Fiscal Service Prompt Payment Interest Rate; Contract Disputes Act... beginning January 1, 2013, and ending on June 30, 2013, the prompt payment interest rate is 1-3/8 per centum... Prompt Payment Act, 31 U.S.C. 3902(a), provide for the calculation of interest due on claims at the rate...

42 CFR 423.520 - Prompt payment by Part D sponsors.

Code of Federal Regulations, 2011 CFR

2011-10-01

... sponsor will issue, mail, or otherwise transmit payment with respect to all clean claims, as defined in... pharmacies) within— (i) 14 days after the date on which the claim is received, as defined in paragraph (a)(2)(i) of this section, for an electronic claim; or (ii) 30 days after the date on which the claim is...

10 CFR 765.21 - Procedures for processing reimbursement claims.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Section 765.21 Energy DEPARTMENT OF ENERGY REIMBURSEMENT FOR COSTS OF REMEDIAL ACTION AT ACTIVE URANIUM AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.21... specified in § 765.20(g) to determine the completeness of each claim. Payments from the Fund to active...

7 CFR 220.14 - Claims against school food authorities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Claims against school food authorities. 220.14 Section 220.14 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE... food authorities. (a) State agencies shall disallow any portion of a claim and recover any payment made...

7 CFR 220.14 - Claims against school food authorities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 4 2014-01-01 2014-01-01 false Claims against school food authorities. 220.14 Section 220.14 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE... food authorities. (a) State agencies shall disallow any portion of a claim and recover any payment made...

Radiology Malpractice Claims in the United States From 2008 to 2012: Characteristics and Implications.

PubMed

Harvey, H Benjamin; Tomov, Elena; Babayan, Astrid; Dwyer, Kathy; Boland, Sam; Pandharipande, Pari V; Halpern, Elkan F; Alkasab, Tarik K; Hirsch, Joshua A; Schaefer, Pamela W; Boland, Giles W; Choy, Garry

2016-02-01

The aim of this study was to compare the frequency and liability costs associated with radiology malpractice claims relative to other medical services and to evaluate the clinical context and case disposition associated with radiology malpractice claims. This HIPAA-compliant study was exempted from institutional review board approval. The Comparative Benchmarking System database, a repository of more than 300,000 medical malpractice cases in the United States, was queried for closed claims over a five-year period (2008-2012). Claims were categorized by the medical service primarily responsible for the claim and the paid total loss. For all cases in which radiology was the primary responsible service, the case abstracts were evaluated to determine injury severity, claimant type by setting, claim allegation, process of care involved, case disposition, modality involved, and body section. Intracategory comparisons were made on the basis of the frequency of indemnity payment and total indemnity payment for paid cases, using χ(2) and Wilcoxon rank-sum tests. Radiology was the eighth most likely responsible service to be implicated in a medical malpractice claim, with a median total paid loss (indemnity payment plus defense cost plus administrative expense) per closed case of $30,091 (mean, $205,619 ± $508,883). Radiology claims were most commonly associated with high- and medium-severity injuries (93.3% [820 of 879]; 95% confidence interval [CI], 91.7%-94.95%), the outpatient setting (66.3% [581 of 876]; 95% CI, 63.0%-69.2%), and diagnosis-related allegations (ie, failure to diagnose or delayed diagnosis) (57.3% [504 of 879]; 95% CI, 54.0%-60.6%). A high proportion of claims pertained to cancer diagnoses (44.0% [222 of 504]; 95% CI, 39.7%-48.3%). A total of 62.3% (548 of 879; 95% CI, 59.1%-65.5%) of radiology claims were closed without indemnity payments; 37.7% (331 of 879; 95% CI, 34.5%-40.9%) were closed with a median indemnity payment of $175,000 (range, $112

7 CFR 215.12 - Claims against schools or child-care institutions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Claims against schools or child-care institutions. 215... § 215.12 Claims against schools or child-care institutions. (a) State agencies, or FNSROs where applicable, shall disallow any portion of a claim and recover any payment made to a School Food Authority or...

39 CFR 601.111 - Interest on claim amounts.

Code of Federal Regulations, 2010 CFR

2010-07-01

... that date is later, until the date of payment. Simple interest will be paid at the rate established by... 39 Postal Service 1 2010-07-01 2010-07-01 false Interest on claim amounts. 601.111 Section 601.111... PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.111 Interest on claim amounts...

12 CFR 370.12 - Payment on the guarantee.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Payment on the guarantee. 370.12 Section 370.12 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY TEMPORARY LIQUIDITY GUARANTEE PROGRAM § 370.12 Payment on the guarantee. (a) Claims for Deposits in...

7 CFR 4288.132 - Payment adjustments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... otherwise payable to the advanced biofuel producer if there is a difference between the amount actually...

7 CFR 4288.132 - Payment adjustments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... to the advanced biofuel producer if there is a difference between the amount actually produced and...

7 CFR 4288.132 - Payment adjustments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... to the advanced biofuel producer if there is a difference between the amount actually produced and...

7 CFR 4288.133 - Payment liability.

Code of Federal Regulations, 2012 CFR

2012-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... lien against the advanced biofuel, or proceeds thereof, in favor of the owner or any other creditor...

7 CFR 4288.133 - Payment liability.

Code of Federal Regulations, 2013 CFR

2013-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... lien against the advanced biofuel, or proceeds thereof, in favor of the owner or any other creditor...

45 CFR 60.7 - Reporting medical malpractice payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Reporting medical malpractice payments. 60.7... PRACTITIONER DATA BANK Reporting of Information § 60.7 Reporting medical malpractice payments. (a) Who must... satisfaction in whole or in part of a claim or a judgment against such health care practitioner for medical...

48 CFR 32.904 - Determining payment due dates.

Code of Federal Regulations, 2014 CFR

2014-10-01

... is subject to contract settlement actions (e.g., release of claims), acceptance is deemed to occur on...) Construction contracts. (1) The due date for making payments on construction contracts is as follows: (i) The... by the clause at 52.232-5, Payments Under Fixed-Price Construction Contracts. (ii) The due date for...

32 CFR 538.2 - Use of military payment certificates.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 538.2 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND... used. Military payment certificates are to be used only in the Department of Defense by authorized... to individuals in and under the Department of Defense. (c) Facilities in which used. Military payment...

TRlCARE Controls Over Claims Prepared by Third-Party Billing Agencies

DTIC Science & Technology

2008-12-31

of the HHS-excluded billing agencies to the TRICARE claims database and saw that payments were sent to the addresses of three billing agencies...contractors and subcontractors responsible for claims processing, including TriWest, Wisconsin Physicians Services, HealthNet, Palmetto Government

41 CFR 105-55.005 - Form of payment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Administration 55-COLLECTION OF CLAIMS OWED THE UNITED STATES § 105-55.005 Form of payment. Claims may be paid in the form of money or, when a contractual basis exists, the General Services Administration may demand the return of specific property or the performance of specific services. ...

Specialty Payment Model Opportunities and Assessment

PubMed Central

Mulcahy, Andrew W.; Chan, Chris; Hirshman, Samuel; Huckfeldt, Peter J.; Kofner, Aaron; Liu, Jodi L.; Lovejoy, Susan L.; Popescu, Ioana; Timbie, Justin W.; Hussey, Peter S.

2015-01-01

Abstract Gastroenterology and cardiology services are common and costly among Medicare beneficiaries. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model. This article describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS). The authors analyzed Medicare claims data to describe the frequency and characteristics of gastroenterology and cardiology index procedures, the practices that delivered index procedures, and the patients that received index procedures. The results of these analyses can help inform CMS decisions about the definition of episodes in an episode-based payment model; payment adjustments for service setting, multiple procedures, or other factors; and eligibility for the payment model. PMID:28083363

32 CFR 199.7 - Claims submission, review, and payment.

Code of Federal Regulations, 2011 CFR

2011-07-01

....g., M.D., Ph.D., R.N., etc.) and provider number, if the individual signing the claim is not the... rendering the care, along with the individual's professional status (e.g., M.D., Ph.D., R.N., etc.). (xi... the beneficiary's signature. (1) Claims for laboratory and diagnostic tests and test interpretations...

32 CFR 199.7 - Claims submission, review, and payment.

Code of Federal Regulations, 2013 CFR

2013-07-01

....g., M.D., Ph.D., R.N., etc.) and provider number, if the individual signing the claim is not the... rendering the care, along with the individual's professional status (e.g., M.D., Ph.D., R.N., etc.). (xi... the beneficiary's signature. (1) Claims for laboratory and diagnostic tests and test interpretations...

32 CFR 199.7 - Claims submission, review, and payment.

Code of Federal Regulations, 2012 CFR

2012-07-01

....g., M.D., Ph.D., R.N., etc.) and provider number, if the individual signing the claim is not the... rendering the care, along with the individual's professional status (e.g., M.D., Ph.D., R.N., etc.). (xi... the beneficiary's signature. (1) Claims for laboratory and diagnostic tests and test interpretations...

26 CFR 302.1-5 - Payment of taxes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ADMINISTRATION TAXES UNDER THE INTERNATIONAL CLAIMS SETTLEMENT ACT, AS AMENDED AUGUST 9, 1955 § 302.1-5 Payment of taxes. (a) Pursuant to tentative computations. The amount of taxes shown by a tentative... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Payment of taxes. 302.1-5 Section 302.1-5...

46 CFR 308.515 - Payment in event of loss.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Ii-Open Policy War Risk Cargo Insurance § 308.515 Payment in event of loss. All... claims must be supported by the customary documents required in connection with war risk insurance claims...

46 CFR 308.515 - Payment in event of loss.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Ii-Open Policy War Risk Cargo Insurance § 308.515 Payment in event of loss. All... claims must be supported by the customary documents required in connection with war risk insurance claims...

46 CFR 308.515 - Payment in event of loss.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Open Policy War Risk Cargo Insurance § 308.515 Payment in event of loss. All... claims must be supported by the customary documents required in connection with war risk insurance claims...

32 CFR 716.7 - Payment of the death gratuity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Payment of the death gratuity. 716.7 Section 716.7 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.7 Payment of the death gratuity. (a) Claim...

32 CFR 716.7 - Payment of the death gratuity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Payment of the death gratuity. 716.7 Section 716.7 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.7 Payment of the death gratuity. (a) Claim...

32 CFR 716.7 - Payment of the death gratuity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Payment of the death gratuity. 716.7 Section 716.7 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.7 Payment of the death gratuity. (a) Claim...

32 CFR 716.7 - Payment of the death gratuity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Payment of the death gratuity. 716.7 Section 716.7 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.7 Payment of the death gratuity. (a) Claim...

32 CFR 716.7 - Payment of the death gratuity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Payment of the death gratuity. 716.7 Section 716.7 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.7 Payment of the death gratuity. (a) Claim...

26 CFR 48.6427-8 - Diesel fuel and kerosene; claims by ultimate purchasers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Diesel fuel and kerosene; claims by ultimate... kerosene; claims by ultimate purchasers. (a) Overview. This section provides rules under which ultimate purchasers of taxed diesel fuel and kerosene may claim the income tax credits or payments allowed by section...

26 CFR 48.6427-8 - Diesel fuel and kerosene; claims by ultimate purchasers.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Diesel fuel and kerosene; claims by ultimate... kerosene; claims by ultimate purchasers. (a) Overview. This section provides rules under which ultimate purchasers of taxed diesel fuel and kerosene may claim the income tax credits or payments allowed by section...

26 CFR 48.6427-8 - Diesel fuel and kerosene; claims by ultimate purchasers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Diesel fuel and kerosene; claims by ultimate... kerosene; claims by ultimate purchasers. (a) Overview. This section provides rules under which ultimate purchasers of taxed diesel fuel and kerosene may claim the income tax credits or payments allowed by section...

26 CFR 48.6427-8 - Diesel fuel and kerosene; claims by ultimate purchasers.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 16 2012-04-01 2012-04-01 false Diesel fuel and kerosene; claims by ultimate... kerosene; claims by ultimate purchasers. (a) Overview. This section provides rules under which ultimate purchasers of taxed diesel fuel and kerosene may claim the income tax credits or payments allowed by section...

7 CFR 4288.113 - Payment record requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment... advanced biofuel producer must maintain records for all relevant fiscal years and fiscal year quarters for each advanced biofuel facility indicating: (a) The type of eligible renewable biomass used in the...

7 CFR 4288.113 - Payment record requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment... advanced biofuel producer must maintain records for all relevant fiscal years and fiscal year quarters for each advanced biofuel facility indicating: (a) The type of eligible renewable biomass used in the...

32 CFR 538.5 - Conversion of invalidated military payment certificates.

Code of Federal Regulations, 2014 CFR

2014-07-01

... certificates. (a) When converted. Time limit on filing claims for the conversion of invalidated Series 461, 471... in effects of deceased personnel. Invalidated series of military payment certificates in amounts not... of death or entry into missing status was prior to the date the series of military payment...

32 CFR 538.5 - Conversion of invalidated military payment certificates.

Code of Federal Regulations, 2011 CFR

2011-07-01

... certificates. (a) When converted. Time limit on filing claims for the conversion of invalidated Series 461, 471... in effects of deceased personnel. Invalidated series of military payment certificates in amounts not... of death or entry into missing status was prior to the date the series of military payment...

32 CFR 538.5 - Conversion of invalidated military payment certificates.

Code of Federal Regulations, 2010 CFR

2010-07-01

... certificates. (a) When converted. Time limit on filing claims for the conversion of invalidated Series 461, 471... in effects of deceased personnel. Invalidated series of military payment certificates in amounts not... of death or entry into missing status was prior to the date the series of military payment...

32 CFR 538.5 - Conversion of invalidated military payment certificates.

Code of Federal Regulations, 2012 CFR

2012-07-01

... certificates. (a) When converted. Time limit on filing claims for the conversion of invalidated Series 461, 471... in effects of deceased personnel. Invalidated series of military payment certificates in amounts not... of death or entry into missing status was prior to the date the series of military payment...

32 CFR 538.5 - Conversion of invalidated military payment certificates.

Code of Federal Regulations, 2013 CFR

2013-07-01

... certificates. (a) When converted. Time limit on filing claims for the conversion of invalidated Series 461, 471... in effects of deceased personnel. Invalidated series of military payment certificates in amounts not... of death or entry into missing status was prior to the date the series of military payment...

17 CFR 300.400 - Satisfaction of customer claims for standardized options.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Satisfaction of customer... CORPORATION Closeout Or Completion of Open Contractual Commitments § 300.400 Satisfaction of customer claims... direct payment procedure pursuant to section 10 of the Act, in satisfaction of a claim based upon...

9 CFR 51.33 - Multiple indemnity payments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... BRUCELLOSIS Indemnity for Sheep, Goats, and Horses § 51.33 Multiple indemnity payments. APHIS has indemnity... destroyed because of brucellosis, no other claims for indemnity will be paid for the same animals. ...

9 CFR 51.33 - Multiple indemnity payments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... BRUCELLOSIS Indemnity for Sheep, Goats, and Horses § 51.33 Multiple indemnity payments. APHIS has indemnity... destroyed because of brucellosis, no other claims for indemnity will be paid for the same animals. ...

9 CFR 51.33 - Multiple indemnity payments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... BRUCELLOSIS Indemnity for Sheep, Goats, and Horses § 51.33 Multiple indemnity payments. APHIS has indemnity... destroyed because of brucellosis, no other claims for indemnity will be paid for the same animals. ...

9 CFR 51.33 - Multiple indemnity payments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... BRUCELLOSIS Indemnity for Sheep, Goats, and Horses § 51.33 Multiple indemnity payments. APHIS has indemnity... destroyed because of brucellosis, no other claims for indemnity will be paid for the same animals. ...

9 CFR 51.33 - Multiple indemnity payments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... BRUCELLOSIS Indemnity for Sheep, Goats, and Horses § 51.33 Multiple indemnity payments. APHIS has indemnity... destroyed because of brucellosis, no other claims for indemnity will be paid for the same animals. ...

Risk Adjustment, Reinsurance Improved Financial Outcomes For Individual Market Insurers With The Highest Claims.

PubMed

Jacobs, Paul D; Cohen, Michael L; Keenan, Patricia

2017-04-01

The Affordable Care Act (ACA) reformed the individual health insurance market. Because insurers can no longer vary their offers of coverage based on applicants' health status, the ACA established a risk adjustment program to equalize health-related cost differences across plans. The ACA also established a temporary reinsurance program to subsidize high-cost claims. To assess the impact of these programs, we compared revenues to claims costs for insurers in the individual market during the first two years of ACA implementation (2014 and 2015), before and after the inclusion of risk adjustment and reinsurance payments. Before these payments were included, for the 30 percent of insurers with the highest claims costs, claims (not including administrative expenses) exceeded premium revenues by $90-$397 per enrollee per month. The effect was reversed after these payments were included, with revenues exceeding claims costs by $0-$49 per month. The risk adjustment and reinsurance programs were relatively well targeted in the first two years. While there is ongoing discussion regarding the future of the ACA, our findings can shed light on how risk-sharing programs can address risk selection among insurers-a pervasive issue in all health insurance markets. Project HOPE—The People-to-People Health Foundation, Inc.

76 FR 38742 - Prompt Payment Interest Rate; Contract Disputes Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-01

... DEPARTMENT OF THE TREASURY Fiscal Service Prompt Payment Interest Rate; Contract Disputes Act... beginning July 1, 2011, and ending on December 31, 2011, the prompt payment interest rate is 2\\1/2\\ per.... 3902(a), provide for the calculation of interest due on claims at the rate established by the Secretary...

76 FR 82350 - Prompt Payment Interest Rate; Contract Disputes Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... DEPARTMENT OF THE TREASURY Fiscal Service Prompt Payment Interest Rate; Contract Disputes Act... beginning January 1, 2012, and ending on June 30, 2012, the prompt payment interest rate is 2 per centum per... of interest due on claims at the rate established by the Secretary of the Treasury. The Secretary of...

77 FR 38888 - Prompt Payment Interest Rate; Contract Disputes Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... DEPARTMENT OF THE TREASURY Fiscal Service Prompt Payment Interest Rate; Contract Disputes Act... beginning July 1, 2012, and ending on December 31, 2012, the prompt payment interest rate is 1\\3/4\\ per... interest due on claims at the rate established by the Secretary of the Treasury. The Secretary of the...

75 FR 82146 - Prompt Payment Interest Rate; Contract Disputes Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... DEPARTMENT OF THE TREASURY Fiscal Service Prompt Payment Interest Rate; Contract Disputes Act... beginning January 1, 2011, and ending on June 30, 2011, the prompt payment interest rate is 2\\5/8\\ per... calculation of interest due on claims at the rate established by the Secretary of the Treasury. The Secretary...

75 FR 37881 - Prompt Payment Interest Rate; Contract Disputes Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... DEPARTMENT OF THE TREASURY Fiscal Service Prompt Payment Interest Rate; Contract Disputes Act... beginning July 1, 2010, and ending on December 31, 2010, the prompt payment interest rate is 3\\1/8\\ per... of interest due on claims at the rate established by the Secretary of the Treasury. The Secretary of...

Frequency and Type of Situational Awareness Errors Contributing to Death and Brain Damage: A Closed Claims Analysis.

PubMed

Schulz, Christian M; Burden, Amanda; Posner, Karen L; Mincer, Shawn L; Steadman, Randolph; Wagner, Klaus J; Domino, Karen B

2017-08-01

Situational awareness errors may play an important role in the genesis of patient harm. The authors examined closed anesthesia malpractice claims for death or brain damage to determine the frequency and type of situational awareness errors. Surgical and procedural anesthesia death and brain damage claims in the Anesthesia Closed Claims Project database were analyzed. Situational awareness error was defined as failure to perceive relevant clinical information, failure to comprehend the meaning of available information, or failure to project, anticipate, or plan. Patient and case characteristics, primary damaging events, and anesthesia payments in claims with situational awareness errors were compared to other death and brain damage claims from 2002 to 2013. Anesthesiologist situational awareness errors contributed to death or brain damage in 198 of 266 claims (74%). Respiratory system damaging events were more common in claims with situational awareness errors (56%) than other claims (21%, P < 0.001). The most common specific respiratory events in error claims were inadequate oxygenation or ventilation (24%), difficult intubation (11%), and aspiration (10%). Payments were made in 85% of situational awareness error claims compared to 46% in other claims (P = 0.001), with no significant difference in payment size. Among 198 claims with anesthesia situational awareness error, perception errors were most common (42%), whereas comprehension errors (29%) and projection errors (29%) were relatively less common. Situational awareness error definitions were operationalized for reliable application to real-world anesthesia cases. Situational awareness errors may have contributed to catastrophic outcomes in three quarters of recent anesthesia malpractice claims.Situational awareness errors resulting in death or brain damage remain prevalent causes of malpractice claims in the 21st century.

45 CFR 30.6 - Form of payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Form of payment. Claims may be paid in the form of money or, when a contractual basis exists, the Department may demand the return of specific property or the performance of specific services. ...

42 CFR 433.139 - Payment of claims.

Code of Federal Regulations, 2011 CFR

2011-10-01

... paragraph (e) of this section, if the agency learns of the existence of a liable third party after a claim... recovery of reimbursement within 60 days after the end of the month it learns of the existence of the... determines that recovery would not be cost effective in accordance with paragraph (f) of this section. (e...

42 CFR 433.139 - Payment of claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... paragraph (e) of this section, if the agency learns of the existence of a liable third party after a claim... recovery of reimbursement within 60 days after the end of the month it learns of the existence of the... determines that recovery would not be cost effective in accordance with paragraph (f) of this section. (e...

41 CFR 301-71.306 - Are there exceptions to collecting an advance at the time the employee files a travel claim?

Code of Federal Regulations, 2014 CFR

2014-07-01

... collecting an advance at the time the employee files a travel claim? 301-71.306 Section 301-71.306 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...-71.306 Are there exceptions to collecting an advance at the time the employee files a travel claim...

41 CFR 301-71.306 - Are there exceptions to collecting an advance at the time the employee files a travel claim?

Code of Federal Regulations, 2013 CFR

2013-07-01

... collecting an advance at the time the employee files a travel claim? 301-71.306 Section 301-71.306 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...-71.306 Are there exceptions to collecting an advance at the time the employee files a travel claim...

41 CFR 301-71.306 - Are there exceptions to collecting an advance at the time the employee files a travel claim?

Code of Federal Regulations, 2012 CFR

2012-07-01

... collecting an advance at the time the employee files a travel claim? 301-71.306 Section 301-71.306 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...-71.306 Are there exceptions to collecting an advance at the time the employee files a travel claim...

41 CFR 301-71.306 - Are there exceptions to collecting an advance at the time the employee files a travel claim?

Code of Federal Regulations, 2010 CFR

2010-07-01

... collecting an advance at the time the employee files a travel claim? 301-71.306 Section 301-71.306 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...-71.306 Are there exceptions to collecting an advance at the time the employee files a travel claim...

41 CFR 301-71.306 - Are there exceptions to collecting an advance at the time the employee files a travel claim?

Code of Federal Regulations, 2011 CFR

2011-07-01

... collecting an advance at the time the employee files a travel claim? 301-71.306 Section 301-71.306 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...-71.306 Are there exceptions to collecting an advance at the time the employee files a travel claim...

24 CFR 207.258b - Partial payment of claim.

Code of Federal Regulations, 2013 CFR

2013-04-01

... potentially could serve as, a low- and moderate-income housing resource; (2) The property covered by the... maintaining the low- and moderate-income character of the project. This determination shall be based upon the...) The relief resulting from partial payment, when considered with other resources available to the...

24 CFR 207.258b - Partial payment of claim.

Code of Federal Regulations, 2012 CFR

2012-04-01

... potentially could serve as, a low- and moderate-income housing resource; (2) The property covered by the... maintaining the low- and moderate-income character of the project. This determination shall be based upon the...) The relief resulting from partial payment, when considered with other resources available to the...

24 CFR 207.258b - Partial payment of claim.

Code of Federal Regulations, 2010 CFR

2010-04-01

... potentially could serve as, a low- and moderate-income housing resource; (2) The property covered by the... maintaining the low- and moderate-income character of the project. This determination shall be based upon the...) The relief resulting from partial payment, when considered with other resources available to the...

24 CFR 207.258b - Partial payment of claim.

Code of Federal Regulations, 2011 CFR

2011-04-01

... potentially could serve as, a low- and moderate-income housing resource; (2) The property covered by the... maintaining the low- and moderate-income character of the project. This determination shall be based upon the...) The relief resulting from partial payment, when considered with other resources available to the...

24 CFR 207.258b - Partial payment of claim.

Code of Federal Regulations, 2014 CFR

2014-04-01

... potentially could serve as, a low- and moderate-income housing resource; (2) The property covered by the... maintaining the low- and moderate-income character of the project. This determination shall be based upon the...) The relief resulting from partial payment, when considered with other resources available to the...

31 CFR 50.54 - Payment of Federal share of compensation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Payment of Federal share of compensation. 50.54 Section 50.54 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Claims Procedures § 50.54 Payment of Federal share of compensation. (a) Timing...

31 CFR 50.54 - Payment of Federal share of compensation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Payment of Federal share of compensation. 50.54 Section 50.54 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Claims Procedures § 50.54 Payment of Federal share of compensation. (a) Timing...

31 CFR 50.54 - Payment of Federal share of compensation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Payment of Federal share of compensation. 50.54 Section 50.54 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Claims Procedures § 50.54 Payment of Federal share of compensation. (a) Timing...

7 CFR 226.14 - Claims against institutions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Payment Provisions § 226.14 Claims... searchable records of funds recovery activities. If the State agency determines that a sponsoring...

36 CFR 72.63 - Grant payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Grant payments. 72.63 Section 72.63 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR URBAN... advance or by way of reimbursement. Advance payments on approved Rehabilitation or Innovation grants will...

32 CFR 842.136 - Claim payments and deposits.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Claims payable for $2500 or less: AAFES Operations Center (OSC-AC), 2727 LBJ Highway, Dallas TX 75266-0320. (b) Civilian base restaurants and civilian welfare NAFIs: (1) For more than $100: Army and Air...

32 CFR 842.136 - Claim payments and deposits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... more than $2500: HQ AAFES, Comptroller, Insurance Branch, P.O. Box 660202, Dallas, TX 75266-0202. (2) Claims payable for $2500 or less: AAFES Operations Center (OSC-AC), 2727 LBJ Highway, Dallas TX 75266...

34 CFR 35.4 - Administrative claim; evidence and information to be submitted.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Administrative claim; evidence and information to be submitted. 35.4 Section 35.4 Education Office of the Secretary, Department of Education TORT CLAIMS AGAINST... bills for medical, dental, and hospital expenses incurred, or itemized receipts of payment for such...

34 CFR 35.4 - Administrative claim; evidence and information to be submitted.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false Administrative claim; evidence and information to be submitted. 35.4 Section 35.4 Education Office of the Secretary, Department of Education TORT CLAIMS AGAINST... bills for medical, dental, and hospital expenses incurred, or itemized receipts of payment for such...

26 CFR 48.6427-11 - Kerosene; claims by registered ultimate vendors (blending).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Kerosene; claims by registered ultimate vendors... Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6427-11 Kerosene... certain registered ultimate vendors of taxed kerosene may claim the income tax credits or payments allowed...

26 CFR 48.6427-11 - Kerosene; claims by registered ultimate vendors (blending).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 16 2012-04-01 2012-04-01 false Kerosene; claims by registered ultimate vendors... Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6427-11 Kerosene... certain registered ultimate vendors of taxed kerosene may claim the income tax credits or payments allowed...

26 CFR 48.6427-11 - Kerosene; claims by registered ultimate vendors (blending).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Kerosene; claims by registered ultimate vendors... Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6427-11 Kerosene... certain registered ultimate vendors of taxed kerosene may claim the income tax credits or payments allowed...

26 CFR 48.6427-11 - Kerosene; claims by registered ultimate vendors (blending).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Kerosene; claims by registered ultimate vendors... Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6427-11 Kerosene... certain registered ultimate vendors of taxed kerosene may claim the income tax credits or payments allowed...

22 CFR 231.12 - Prosecution of claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND... exclusive power to prosecute all claims related to rights to receive payments under the Eligible Notes to...

Contrary to cost-shift theory, lower Medicare hospital payment rates for inpatient care lead to lower private payment rates.

PubMed

White, Chapin

2013-05-01

Many policy makers believe that when Medicare constrains its payment rates for hospital inpatient care, private insurers end up paying higher rates as a result. I tested this "cost-shifting" theory using a unique new data set that combines MarketScan private claims data with Medicare hospital cost reports. Contrary to the theory, I found that hospital markets with relatively slow growth in Medicare inpatient hospital payment rates also had relatively slow growth in private hospital payment rates during 1995-2009. Using regression analyses, I found that a 10 percent reduction in Medicare payment rates led to an estimated reduction in private payment rates of 3 percent or 8 percent, depending on the statistical model used. These payment rate spillovers may reflect an effort by hospitals to rein in their operating costs in the face of lower Medicare payment rates. Alternatively, hospitals facing cuts in Medicare payment rates may also cut the payment rates they seek from private payers to attract more privately insured patients. My findings indicate that repealing cuts in Medicare payment rates would not slow the growth in spending on hospital care by private insurers and would in fact be likely to accelerate the growth in private insurers' costs and premiums.

Commentary: Binding Early Offers versus Caps for Medical Malpractice Claims?

PubMed Central

O'Connell, Jeffrey

2007-01-01

Like damages caps, early offer reform promises reduction in the costs of medical liability cases. In contrast to damages caps, early offer reform offers advantages to both claimant and defendant. Under early offer, the defendant would have the option to offer an injured patient periodic payments for the patient's net economic losses as they accrue, but not payments for noneconomic losses (pain and suffering). If an early offer were made and accepted, that would settle the claim. This commentary1 explains how an early offer reform might work and summarizes data from a recent closed claim study of medical malpractice cases in Texas and Florida. The data show widespread opportunities for successful early offers and provide evidence that substantial per case savings would result. PMID:17517116

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

7 CFR 210.8 - Claims for reimbursement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... lunches and meal supplements by reimbursement type served to children times the respective payment rates... problems with a school's meal counting or claiming procedures, the school food authority shall: ensure that... found by its most recent administrative review conducted in accordance with § 210.18, to have no meal...

7 CFR 226.14 - Claims against institutions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Payment Provisions § 226.14 Claims... organization of centers has spent more than 15 percent of its meal reimbursements for a budget year for...

7 CFR 226.14 - Claims against institutions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Payment Provisions § 226.14 Claims... organization of centers has spent more than 15 percent of its meal reimbursements for a budget year for...

7 CFR 226.14 - Claims against institutions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Payment Provisions § 226.14 Claims... organization of centers has spent more than 15 percent of its meal reimbursements for a budget year for...

7 CFR 226.14 - Claims against institutions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Payment Provisions § 226.14 Claims... organization of centers has spent more than 15 percent of its meal reimbursements for a budget year for...

42 CFR 412.76 - Recovery of excess transition period payment amounts resulting from unlawful claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR... 42 Public Health 2 2010-10-01 2010-10-01 false Recovery of excess transition period payment... System for Inpatient Operating Costs § 412.76 Recovery of excess transition period payment amounts...

40 CFR 35.4090 - If my group is eligible for an advance payment, how do we get our funds?

Code of Federal Regulations, 2010 CFR

2010-07-01

... approval of your request, EPA will advance cash (in the form of a check or electronic funds transfer) to... 40 Protection of Environment 1 2010-07-01 2010-07-01 false If my group is eligible for an advance... Assistance How You Get the Money § 35.4090 If my group is eligible for an advance payment, how do we get our...

32 CFR Appendix to Part 281 - Claims Description

Code of Federal Regulations, 2010 CFR

2010-07-01

... advance decision functions for claims under the following statutes: (a) 31 U.S.C. 3702, concerning claims... SETTLING PERSONNEL AND GENERAL CLAIMS AND PROCESSING ADVANCE DECISION REQUESTS Pt. 281, App. Appendix to... Personnel Management performs these functions for claims involving civilian employees' compensation and...

28 CFR 104.51 - Payments to eligible individuals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... regarding potential future claims and available funds, and may make additional payments in light of such... amount that is equal to the difference between: (i) The amount that the claimant would have been paid...

76 FR 52862 - Time for Payment of Certain Excise Taxes, and Quarterly Excise Tax Payments for Small Alcohol...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... 40 Cigars and cigarettes, Claims, Electronic fund transfers, Excise taxes, Labeling, Packaging and... that are not required to pay taxes through electronic funds transfer (EFT), this first payment period..., Electronic funds transfers, Excise taxes, Exports, Food additives, Fruit juices, Labeling, Liquors, Packaging...

26 CFR 48.6427-10 - Kerosene; claims by registered ultimate vendors (blocked pumps).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 16 2012-04-01 2012-04-01 false Kerosene; claims by registered ultimate vendors... Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6427-10 Kerosene... which certain registered ultimate vendors of taxed kerosene may claim the income tax credits or payments...

26 CFR 48.6427-10 - Kerosene; claims by registered ultimate vendors (blocked pumps).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Kerosene; claims by registered ultimate vendors... Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6427-10 Kerosene... which certain registered ultimate vendors of taxed kerosene may claim the income tax credits or payments...

26 CFR 48.6427-10 - Kerosene; claims by registered ultimate vendors (blocked pumps).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Kerosene; claims by registered ultimate vendors... Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6427-10 Kerosene... which certain registered ultimate vendors of taxed kerosene may claim the income tax credits or payments...

26 CFR 48.6427-10 - Kerosene; claims by registered ultimate vendors (blocked pumps).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Kerosene; claims by registered ultimate vendors... Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6427-10 Kerosene... which certain registered ultimate vendors of taxed kerosene may claim the income tax credits or payments...

41 CFR 301-52.14 - What must I do with any travel advance outstanding at the time I submit my travel claim?

Code of Federal Regulations, 2013 CFR

2013-07-01

... travel advance outstanding at the time I submit my travel claim? 301-52.14 Section 301-52.14 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES... § 301-52.14 What must I do with any travel advance outstanding at the time I submit my travel claim? You...

41 CFR 301-52.14 - What must I do with any travel advance outstanding at the time I submit my travel claim?

Code of Federal Regulations, 2010 CFR

2010-07-01

... travel advance outstanding at the time I submit my travel claim? 301-52.14 Section 301-52.14 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES... § 301-52.14 What must I do with any travel advance outstanding at the time I submit my travel claim? You...

41 CFR 301-52.14 - What must I do with any travel advance outstanding at the time I submit my travel claim?

Code of Federal Regulations, 2012 CFR

2012-07-01

... travel advance outstanding at the time I submit my travel claim? 301-52.14 Section 301-52.14 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES... § 301-52.14 What must I do with any travel advance outstanding at the time I submit my travel claim? You...

41 CFR 301-52.14 - What must I do with any travel advance outstanding at the time I submit my travel claim?

Code of Federal Regulations, 2014 CFR

2014-07-01

... travel advance outstanding at the time I submit my travel claim? 301-52.14 Section 301-52.14 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES... § 301-52.14 What must I do with any travel advance outstanding at the time I submit my travel claim? You...

41 CFR 301-52.14 - What must I do with any travel advance outstanding at the time I submit my travel claim?

Code of Federal Regulations, 2011 CFR

2011-07-01

... travel advance outstanding at the time I submit my travel claim? 301-52.14 Section 301-52.14 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES... § 301-52.14 What must I do with any travel advance outstanding at the time I submit my travel claim? You...

20 CFR 422.303 - Interest, late payment penalties, and administrative costs of collection.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Interest, late payment penalties, and administrative costs of collection. 422.303 Section 422.303 Employees' Benefits SOCIAL SECURITY ADMINISTRATION ORGANIZATION AND PROCEDURES Claims Collection § 422.303 Interest, late payment penalties, and administrative...

76 FR 13329 - Reinstatement of Coverage Pertaining to Final Payment Under Construction and Building Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

..., Release of Claims, for releases of claims under construction and building service contracts, was... prescribed the use of GSA Form 1142 for releases of claims under construction and building service contracts...] RIN 3090-AJ13 Reinstatement of Coverage Pertaining to Final Payment Under Construction and Building...

42 CFR 412.624 - Methodology for calculating the Federal prospective payment rates.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Adjustments for teaching hospitals. For discharges on or after October 1, 2005, CMS adjusts the Federal prospective payment on a facility basis by a factor as specified by CMS for facilities that are teaching institutions or units of teaching institutions. This adjustment is made on a claim basis as an interim payment...

78 FR 64536 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Claim for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... the War Hazards Compensation Act ACTION: Notice. SUMMARY: The Department of Labor (DOL) is submitting... DEPARTMENT OF LABOR Office of the Secretary Agency Information Collection Activities; Submission...) revision titled, ``Claim for Reimbursement of Benefit Payments and Claims Expense under the War Hazards...

32 CFR 842.64 - Payment criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Payment criteria. 842.64 Section 842.64 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE CLAIMS AND LITIGATION ADMINISTRATIVE... States. It must be caused by noncombatant activities of the US Armed Forces or by civilian employees or...

40 CFR 35.2300 - Grant payments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ASSISTANCE Grants for Construction of Treatment Works § 35.2300 Grant payments. Except as provided in § 35... States, its officers, agents, and employees from all liabilities, obligations, and claims arising out of... State shall provide a copy of the agreement to EPA. (f) Design/build projects. For design/build projects...

40 CFR 35.2300 - Grant payments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ASSISTANCE Grants for Construction of Treatment Works § 35.2300 Grant payments. Except as provided in § 35... States, its officers, agents, and employees from all liabilities, obligations, and claims arising out of... State shall provide a copy of the agreement to EPA. (f) Design/build projects. For design/build projects...

40 CFR 35.2300 - Grant payments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ASSISTANCE Grants for Construction of Treatment Works § 35.2300 Grant payments. Except as provided in § 35... States, its officers, agents, and employees from all liabilities, obligations, and claims arising out of... State shall provide a copy of the agreement to EPA. (f) Design/build projects. For design/build projects...

40 CFR 35.2300 - Grant payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ASSISTANCE Grants for Construction of Treatment Works § 35.2300 Grant payments. Except as provided in § 35... States, its officers, agents, and employees from all liabilities, obligations, and claims arising out of... State shall provide a copy of the agreement to EPA. (f) Design/build projects. For design/build projects...

40 CFR 35.2300 - Grant payments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ASSISTANCE Grants for Construction of Treatment Works § 35.2300 Grant payments. Except as provided in § 35... States, its officers, agents, and employees from all liabilities, obligations, and claims arising out of... State shall provide a copy of the agreement to EPA. (f) Design/build projects. For design/build projects...

32 CFR Appendix B to Part 282 - Claims Description

Code of Federal Regulations, 2010 CFR

2010-07-01

... perform the claims settlement and advance decision functions for claims under the following statutes: (a...) MISCELLANEOUS PROCEDURES FOR SETTLING PERSONNEL AND GENERAL CLAIMS AND PROCESSING ADVANCE DECISION REQUESTS Pt... Director of the Office of Personnel Management performs these functions for claims involving civilian...

38 CFR 6.7 - Claims of creditors, taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Claims of creditors, taxation. 6.7 Section 6.7 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS UNITED... creditors, taxation. (a) Effective January 1, 1958, payments of insurance to a beneficiary under a United...

38 CFR 6.7 - Claims of creditors, taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Claims of creditors, taxation. 6.7 Section 6.7 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS UNITED... creditors, taxation. (a) Effective January 1, 1958, payments of insurance to a beneficiary under a United...

Variation in payments for spine surgery episodes of care: implications for episode-based bundled payment.

PubMed

Kahn, Elyne N; Ellimoottil, Chandy; Dupree, James M; Park, Paul; Ryan, Andrew M

2018-05-25

OBJECTIVE Spine surgery is expensive and marked by high variation across regions and providers. Bundled payments have potential to reduce unwarranted spending associated with spine surgery. This study is a cross-sectional analysis of commercial and Medicare claims data from January 2012 through March 2015 in the state of Michigan. The objective was to quantify variation in payments for spine surgery in adult patients, document sources of variation, and determine influence of patient-level, surgeon-level, and hospital-level factors. METHODS Hierarchical regression models were used to analyze contributions of patient-level covariates and influence of individual surgeons and hospitals. The primary outcome was price-standardized 90-day episode payments. Intraclass correlation coefficients-measures of variability accounted for by each level of a hierarchical model-were used to quantify sources of spending variation. RESULTS The authors analyzed 17,436 spine surgery episodes performed by 195 surgeons at 50 hospitals. Mean price-standardized 90-day episode payments in the highest spending quintile exceeded mean payments for episodes in the lowest cost quintile by $42,953 (p < 0.001). Facility payments for index admission and post-discharge payments were the greatest contributors to overall variation: 39.4% and 32.5%, respectively. After accounting for patient-level covariates, the remaining hospital-level and surgeon-level effects accounted for 2.0% (95% CI 1.1%-3.8%) and 4.0% (95% CI 2.9%-5.6%) of total variation, respectively. CONCLUSIONS Significant variation exists in total episode payments for spine surgery, driven mostly by variation in post-discharge and facility payments. Hospital and surgeon effects account for relatively little of the observed variation.

MACRA, Alternative Payment Models, and the Physician-Focused Payment Model: Implications for Radiology.

PubMed

Rosenkrantz, Andrew B; Nicola, Gregory N; Allen, Bibb; Hughes, Danny R; Hirsch, Joshua A

2017-06-01

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 describes alternative payment models (APMs) as new approaches to health care payment that incentivize higher quality and value. MACRA incentivizes increasing APM participation by all physician specialties over the coming years. Some APMs will be deemed Advanced APMs; clinicians who are a Qualifying Participant in an Advanced APM will receive substantial benefits under MACRA including an automatic 5% payment bonus, regardless of their performance and savings within the APM, and a larger payment rate increase beginning in 2026. Existing APMs are most relevant to primary care physicians, and opportunities for radiologists to participate in Advanced APMs fulfilling Qualified Participant requirements are limited. Physician-Focused Payment Models (PFPMs), as described in MACRA, are APMs that target physicians' Medicare payments based on quality and cost of physician services. PFPMs must address a new issue or specialty compared with existing APMs and will thus foster a more diverse range of APMs encompassing a wider range of specialties. The PFPM Technical Advisory Committee is a new independent agency that will review proposals for new PFPMs and provide recommendations to CMS regarding their approval. The PFPM Technical Advisory Committee comprises largely primary care physicians and health policy experts and is not required to consult clinical experts when reviewing new specialist-proposed PFPMs. As PFPMs provide a compelling opportunity for radiologists to demonstrate and be rewarded for their unique contributions toward patient care, radiologists should embrace this new model and actively partner with other stakeholders in developing radiology-relevant PFPMs. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Twenty Years of Evidence on the Outcomes of Malpractice Claims

PubMed Central

2008-01-01

Two decades of social science research on the outcomes of medical malpractice claims show malpractice outcomes bear a surprisingly good correlation with the quality of care provided to the patient as judged by other physicians. Physicians win 80% to 90% of the jury trials with weak evidence of medical negligence, approximately 70% of the borderline cases, and even 50% of the trials in cases with strong evidence of medical negligence. With only one exception, all of the studies of malpractice settlements also find a correlation between the odds of a settlement payment and the quality of care provided to the plaintiff. Between 80% and 90% of the claims rated as defensible are dropped or dismissed without payment. In addition, the amount paid in settlement drops as the strength of the patient’s evidence weakens. PMID:19048355

42 CFR 457.614 - General payment process.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... described in § 457.630; (2) Tracks and applies Federal payments claimed quarterly by each State, the... applicable allotments for the fiscal year; and (3) Track and apply relevant State, District of Columbia...

42 CFR 457.614 - General payment process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... described in § 457.630; (2) Tracks and applies Federal payments claimed quarterly by each State, the... applicable allotments for the fiscal year; and (3) Track and apply relevant State, District of Columbia...

7 CFR 3430.51 - Payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION... payments will be made in advance unless a deviation is accepted (see § 3430.3) or as specified in paragraph... Standard Application for Payments (ASAP) system, or another electronic funds transfer (EFT) method, except...

24 CFR 235.375 - Termination, suspension, or reinstatement of the assistance payments contract.

Code of Federal Regulations, 2010 CFR

2010-04-01

... obtaining of wage and claim information from State Wage Information Collection Agencies, as provided by part... HOME OWNERSHIP AND PROJECT REHABILITATION Assistance Payments-Homes for Lower Income Families § 235.375... consent forms for the obtaining of wage and claim information from State Wage Information Collection...

24 CFR 17.159 - Application of offset funds: Federal payment is insufficient to cover amount of debt.

Code of Federal Regulations, 2010 CFR

2010-04-01

...: Federal payment is insufficient to cover amount of debt. 17.159 Section 17.159 Housing and Urban... Procedures for the Collection of Claims by the Government Irs Tax Refund and Federal Payment Offset... insufficient to cover amount of debt. If an offset of a Federal payment is insufficient to satisfy a debt, the...

Trends in medical malpractice claims in patients with cleft or craniofacial abnormalities in the United States.

PubMed

Rawal, Rounak B; Kilpatrick, Lauren A; Wood, Jeyhan S; Drake, Amelia F

2016-11-01

To describe medical malpractice trends in patients with cleft and/or craniofacial abnormalities. A modified Delphi approach was used to gather search terms. Search settings included "all jury verdicts and settlements", with jurisdiction of "all states" and "all federal courts" (by court and circuit). A retrospective review of WestLawNext legal database was conducted. Cases were excluded if they did not have a direct association from the patient's craniofacial anomaly or if they were not related to malpractice. Forty-two cases met inclusion criteria. Cases closed between 1981 and 2014 were included. The mean payment among claims with an indemnity payment was $3.9 million. Of cases brought to trial, 62% were in favor of the plaintiff. Amongst physicians named as co-defendants, pediatricians were most commonly named (24%), followed by plastic surgeons (16%), obstetricians (7.8%), and radiologists (7.8%). "Missed diagnosis" was the most common type of negligent claim (45%), followed by "surgical error" (21%), and "medication error" (17%). "Anoxic brain injury" resulted in the highest median indemnity payment for complication of patient management ($3.5 million), followed by "wrongful birth" ($1.03 million), and "minor physical injury" ($520,000). No specific type of negligent claim (p = 0.764) nor complication of patient management (p = 0.61) was associated with a greater indemnity payment. Mean indemnity payment was $920,000 prior to 2001 and $4.4 million after 2001 (p = 0.058). Mean indemnity payments were fourteen-fold greater in patients as compared to those in the overall population ($3.9 million versus $274,887) and seven-fold greater than those in the average pediatric population ($3.9 million versus $520,923). All healthcare providers should be aware of the associated medical malpractice claims that may be incurred when treating patients at risk for these conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Cash for carbon: A randomized trial of payments for ecosystem services to reduce deforestation.

PubMed

Jayachandran, Seema; de Laat, Joost; Lambin, Eric F; Stanton, Charlotte Y; Audy, Robin; Thomas, Nancy E

2017-07-21

We evaluated a program of payments for ecosystem services in Uganda that offered forest-owning households annual payments of 70,000 Ugandan shillings per hectare if they conserved their forest. The program was implemented as a randomized controlled trial in 121 villages, 60 of which received the program for 2 years. The primary outcome was the change in land area covered by trees, measured by classifying high-resolution satellite imagery. We found that tree cover declined by 4.2% during the study period in treatment villages, compared to 9.1% in control villages. We found no evidence that enrollees shifted their deforestation to nearby land. We valued the delayed carbon dioxide emissions and found that this program benefit is 2.4 times as large as the program costs. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

7 CFR 226.10 - Program payment procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Payment Provisions § 226.10 Program... claimed and to enable the State agency to provide the final Report of the Child and Adult Care Food...

7 CFR 226.10 - Program payment procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Payment Provisions § 226.10 Program... claimed and to enable the State agency to provide the final Report of the Child and Adult Care Food...

7 CFR 226.10 - Program payment procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Payment Provisions § 226.10 Program... claimed and to enable the State agency to provide the final Report of the Child and Adult Care Food...

Using Medical Claims for Policy Effectiveness Surveillance: Reimbursement and Utilization of Abdomen/Pelvis Computed Tomography Scans.

PubMed

Horný, Michal; Morgan, Jake R; Merker, Vanessa L

2015-12-01

To quantify changes in private insurance payments for and utilization of abdominal/pelvic computed tomography scans (CTs) after 2011 changes in CPT coding and Medicare reimbursement rates, which were designed to reduce costs stemming from misvalued procedures. TruvenHealth Analytics MarketScan Commercial Claims and Encounters database. We used difference-in-differences models to compare combined CTs of the abdomen/pelvis to CTs of the abdomen or pelvis only. Our main outcomes were inflation-adjusted log payments per procedure, daily utilization rates, and total annual payments. Claims data were extracted for all abdominal/pelvic CTs performed in 2009-2011 within noncapitated, employer-sponsored private plans. Adjusted payments per combined CTs of the abdomen/pelvis dropped by 23.8 percent (p < .0001), and their adjusted daily utilization rate accelerated by 0.36 percent (p = .034) per month after January 2011. Utilization rate of abdominal-only or pelvic-only CTs dropped by 5.0 percent (p < .0001). Total annual payments for combined CTs of the abdomen/pelvis decreased in 2011 despite the increased utilization. Private insurance payments for combined CTs of the abdomen/pelvis declined and utilization accelerated significantly after 2011 policy changes. While growth in total annual payments was contained in 2011, it may not be sustained if 2011 utilization trends persist. © Health Research and Educational Trust.

Pediatric radiology malpractice claims - characteristics and comparison to adult radiology claims.

PubMed

Breen, Micheál A; Dwyer, Kathy; Yu-Moe, Winnie; Taylor, George A

2017-06-01

Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation. We hypothesize that the frequency, character and outcome of malpractice claims made against pediatric radiologists differ from those seen in general radiology practice. We searched the Controlled Risk Insurance Co. (CRICO) Strategies' Comparative Benchmarking System (CBS), a private repository of approximately 350,000 open and closed medical malpractice claims in the United States, for claims related to pediatric radiology. We further queried these cases for the major allegation, the clinical environment in which the claim arose, the clinical severity of the alleged injury, indemnity paid (if payment was made), primary imaging modality involved (if applicable) and primary International Classification of Diseases, 9th revision (ICD-9) diagnosis underlying the claim. There were a total of 27,056 fully coded claims of medical malpractice in the CBS database in the 5-year period between Jan. 1, 2010, and Dec. 31, 2014. Of these, 1,472 cases (5.4%) involved patients younger than 18 years. Radiology was the primary service responsible for 71/1,472 (4.8%) pediatric cases. There were statistically significant differences in average payout for pediatric radiology claims ($314,671) compared to adult radiology claims ($174,033). The allegations were primarily diagnosis-related in 70% of pediatric radiology claims. The most common imaging modality implicated in

Medicare Part D payments for neurologist-prescribed drugs

PubMed Central

Burke, James F.; Kerber, Kevin A.; Skolarus, Lesli E.; Callaghan, Brian C.

2016-01-01

Objective: To describe neurologists' Medicare Part D prescribing patterns and the potential effect of generic substitutions and price negotiation, which is currently prohibited. Methods: The 2013 Medicare Part D Prescriber Public Use and Summary files were used. Payments for medications were aggregated by provider and drug (brand or generic). Payment, proportion of generic claims or day's supply, and median payment per monthly supply of medication were calculated by physician specialty and drug. Savings from generic substitution were estimated for brand drugs with a generic available. Medicare prices were compared to drug prices negotiated by the federal government with pharmaceutical manufacturers for the Veterans Administration (VA). Results: Neurologists comprised 13,060 (1.2%) providers with $5.0 billion (4.8%) in total payments, third highest of all specialties, with a median monthly payment of $141 (interquartile range $85–225). Multiple sclerosis drugs had the highest payments ($1.8 billion). Within neurologic disease groups ($3.4 billion in payments), 54.2%–91.8% of monthly supplies were generic, but 11.9%–71.3% of the payment was for generic medications. Generic substitution resulted in a $269 million (6.5%) payment decrease. VA pricing resulted in $1.5 billion (44.5% of $3.4 billion) in savings. Conclusions: High payment per monthly supply of medication underlies the high total neurology drug payments and is driven by multiple sclerosis drugs. Lowering drug expenditures by Medicare should focus on drug prices. PMID:27009256

38 CFR 21.4138 - Certifications and release of payments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Administration of Educational Assistance Programs Payments; Educational Assistance Allowance § 21.4138 Certifications and release of... Processing Office of jurisdiction for educational assistance allowance claims processed under 38 U.S.C...

38 CFR 21.4138 - Certifications and release of payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Administration of Educational Assistance Programs Payments; Educational Assistance Allowance § 21.4138 Certifications and release of... Processing Office of jurisdiction for educational assistance allowance claims processed under 38 U.S.C...

41 CFR 302-10.301 - May I receive an advance of funds when payment is made directly to the carrier by my agency?

Code of Federal Regulations, 2010 CFR

2010-07-01

... PRIMARY RESIDENCE Advance of Funds § 302-10.301 May I receive an advance of funds when payment is made directly to the carrier by my agency? No, your agency will not authorize you an advance of funds when it... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May I receive an advance...

42 CFR 495.208 - Avoiding duplicate payment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.208 Avoiding duplicate payment. (a) CMS requires a qualifying MA organization that registers MA EPs for the purpose of participating in the MA EHR Incentive Program to notify each of the MA EPs for which it is claiming an incentive...

42 CFR 495.208 - Avoiding duplicate payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.208 Avoiding duplicate payment. (a) CMS requires a qualifying MA organization that registers MA EPs for the purpose of participating in the MA EHR Incentive Program to notify each of the MA EPs for which it is claiming an incentive...

Diagnosis-Based Risk Adjustment for Medicare Capitation Payments

PubMed Central

Ellis, Randall P.; Pope, Gregory C.; Iezzoni, Lisa I.; Ayanian, John Z.; Bates, David W.; Burstin, Helen; Ash, Arlene S.

1996-01-01

Using 1991-92 data for a 5-percent Medicare sample, we develop, estimate, and evaluate risk-adjustment models that utilize diagnostic information from both inpatient and ambulatory claims to adjust payments for aged and disabled Medicare enrollees. Hierarchical coexisting conditions (HCC) models achieve greater explanatory power than diagnostic cost group (DCG) models by taking account of multiple coexisting medical conditions. Prospective models predict average costs of individuals with chronic conditions nearly as well as concurrent models. All models predict medical costs far more accurately than the current health maintenance organization (HMO) payment formula. PMID:10172666

20 CFR 30.100 - In general, how does an employee file an initial claim for benefits?

Code of Federal Regulations, 2013 CFR

2013-04-01

... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS... employee may not want to claim for an occupational illness or a covered illness for which a payment has...

26 CFR 48.6427-9 - Diesel fuel and kerosene; claims by registered ultimate vendors (farming and State use).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 16 2012-04-01 2012-04-01 false Diesel fuel and kerosene; claims by registered... Manufacturers Taxes § 48.6427-9 Diesel fuel and kerosene; claims by registered ultimate vendors (farming and... taxed diesel fuel and kerosene may claim the income tax credits or payments allowed by section 6427(l)(5...

26 CFR 48.6427-9 - Diesel fuel and kerosene; claims by registered ultimate vendors (farming and State use).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Diesel fuel and kerosene; claims by registered... Manufacturers Taxes § 48.6427-9 Diesel fuel and kerosene; claims by registered ultimate vendors (farming and... taxed diesel fuel and kerosene may claim the income tax credits or payments allowed by section 6427(l)(5...

26 CFR 48.6427-9 - Diesel fuel and kerosene; claims by registered ultimate vendors (farming and State use).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Diesel fuel and kerosene; claims by registered... Manufacturers Taxes § 48.6427-9 Diesel fuel and kerosene; claims by registered ultimate vendors (farming and... taxed diesel fuel and kerosene may claim the income tax credits or payments allowed by section 6427(l)(5...

26 CFR 48.6427-9 - Diesel fuel and kerosene; claims by registered ultimate vendors (farming and State use).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Diesel fuel and kerosene; claims by registered... Manufacturers Taxes § 48.6427-9 Diesel fuel and kerosene; claims by registered ultimate vendors (farming and... taxed diesel fuel and kerosene may claim the income tax credits or payments allowed by section 6427(l)(5...

Specialty Payment Model Opportunities and Assessment

PubMed Central

White, Chapin; Chan, Chris; Huckfeldt, Peter J.; Kofner, Aaron; Mulcahy, Andrew W.; Pollak, Julia; Popescu, Ioana; Timbie, Justin W.; Hussey, Peter S.

2015-01-01

Abstract This article describes the results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). CMS asked MITRE and RAND to conduct simulation analyses to preview some of the possible impacts of the payment model and to inform design decisions related to the model. The simulation analysis used an episode-level dataset based on Medicare fee-for-service (FFS) claims for historical oncology episodes provided to Medicare FFS beneficiaries in 2010. Under the proposed model, participating practices would continue to receive FFS payments, would also receive per-beneficiary per-month care management payments for episodes lasting up to six months, and would be eligible for performance-based payments based on per-episode spending for attributed episodes relative to a per-episode spending target. The simulation offers several insights into the proposed payment model for oncology: (1) The care management payments used in the simulation analysis—$960 total per six-month episode—represent only 4 percent of projected average total spending per episode (around $27,000 in 2016), but they are large relative to the FFS revenues of participating oncology practices, which are projected to be around $2,000 per oncology episode. By themselves, the care management payments would increase physician practices’ Medicare revenues by roughly 50 percent on average. This represents a substantial new outlay for the Medicare program and a substantial new source of revenues for oncology practices. (2) For the Medicare program to break even, participating oncology practices would have to reduce utilization and intensity by roughly 4 percent. (3) The break-even point can be reduced if the care management payments are reduced or if the performance-based payments are reduced. PMID:28083365

Association of Industry Payments to Physicians With the Prescribing of Brand-name Statins in Massachusetts.

PubMed

Yeh, James S; Franklin, Jessica M; Avorn, Jerry; Landon, Joan; Kesselheim, Aaron S

2016-06-01

Pharmaceutical industry payments to physicians may affect prescribing practices and increase costs if more expensive medications are prescribed. Determine the association between industry payments to physicians and the prescribing of brand-name as compared with generic statins for lowering cholesterol. Cross-sectional linkage of the Part D Medicare prescriptions claims data with the Massachusetts physicians payment database including all licensed Massachusetts physicians who wrote prescriptions for statins paid for under the Medicare drug benefit in 2011. The exposure variable was a physician's industry payments as listed in the Massachusetts database. The outcome was the physician's rate of prescribing brand-name statins. We used linear regression to analyze the association between the intensity of physicians' industry relationships (as measured by total payments) and their prescribing practices, as well as the effects of specific types of payments. Among the 2444 Massachusetts physicians in the Medicare prescribing database in 2011, 899 (36.8%) received industry payments. The most frequent payment was for company-sponsored meals (n = 639 [71.1%]). Statins accounted for 1 559 003 prescription claims; 356 807 (22.8%) were for brand-name drugs. For physicians with no industry payments listed, the median brand-name statin prescribing rate was 17.8% (95% CI, 17.2%-18.4%). For every $1000 in total payments received, the brand-name statin prescribing rate increased by 0.1% (95% CI, 0.06%-0.13%; P < .001). Payments for educational training were associated with a 4.8% increase in the rate of brand-name prescribing (P = .004); other forms of payments were not. Industry payments to physicians are associated with higher rates of prescribing brand-name statins. As the United States seeks to rein in the costs of prescription drugs and make them less expensive for patients, our findings are concerning.

20 CFR 61.300 - Payment of detention benefits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Payment of detention benefits. 61.300 Section 61.300 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR COMPENSATION... CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, AS AMENDED Detention Benefits § 61.300...

20 CFR 61.300 - Payment of detention benefits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Payment of detention benefits. 61.300 Section 61.300 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR COMPENSATION... CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, AS AMENDED Detention Benefits § 61.300...

20 CFR 61.300 - Payment of detention benefits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Payment of detention benefits. 61.300 Section 61.300 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR COMPENSATION... CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, AS AMENDED Detention Benefits § 61.300...

24 CFR 201.55 - Calculation of insurance claim payment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... insurance coverage reserve account established by the Secretary under § 201.32, if the insurance claim is... (net unpaid principal and the uncollected interest earned to the date of default, calculated according... (net unpaid principal and the uncollected interest earned to the date of default, calculated according...

Specialty Payment Model Opportunities and Assessment: Gastroenterology and Cardiology Model Design Report.

PubMed

Mulcahy, Andrew W; Chan, Chris; Hirshman, Samuel; Huckfeldt, Peter J; Kofner, Aaron; Liu, Jodi L; Lovejoy, Susan L; Popescu, Ioana; Timbie, Justin W; Hussey, Peter S

2015-07-15

Gastroenterology and cardiology services are common and costly among Medicare beneficiaries. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model. This article describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS). The authors analyzed Medicare claims data to describe the frequency and characteristics of gastroenterology and cardiology index procedures, the practices that delivered index procedures, and the patients that received index procedures. The results of these analyses can help inform CMS decisions about the definition of episodes in an episode-based payment model; payment adjustments for service setting, multiple procedures, or other factors; and eligibility for the payment model.

49 CFR 1018.20 - Written demand for payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Written demand for payment. 1018.20 Section 1018.20 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION GENERAL RULES AND REGULATIONS DEBT COLLECTION Administrative Collection of Claims § 1018.20 Written demand for...

42 CFR 412.76 - Recovery of excess transition period payment amounts resulting from unlawful claims.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Recovery of excess transition period payment... System for Inpatient Operating Costs § 412.76 Recovery of excess transition period payment amounts... the base period and the additional amounts paid due to the inappropriate increase of the hospital...

42 CFR 412.76 - Recovery of excess transition period payment amounts resulting from unlawful claims.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Recovery of excess transition period payment... System for Inpatient Operating Costs § 412.76 Recovery of excess transition period payment amounts... the base period and the additional amounts paid due to the inappropriate increase of the hospital...

42 CFR 412.76 - Recovery of excess transition period payment amounts resulting from unlawful claims.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Recovery of excess transition period payment... System for Inpatient Operating Costs § 412.76 Recovery of excess transition period payment amounts... the base period and the additional amounts paid due to the inappropriate increase of the hospital...

42 CFR 412.76 - Recovery of excess transition period payment amounts resulting from unlawful claims.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Recovery of excess transition period payment... System for Inpatient Operating Costs § 412.76 Recovery of excess transition period payment amounts... the base period and the additional amounts paid due to the inappropriate increase of the hospital...

20 CFR 416.520 - Emergency advance payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of expected eligibility for payment of benefits. (2) For a couple, we separately compute each member... not established. If a presumptively eligible individual (or spouse) or couple is determined to be...

20 CFR 702.221 - Claims for compensation; time limitations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... which the injury or death occurred. The Social Security Number (SSN) of the injured employee and, in... year of the injury or death, or (where payment is made without an award) within one year of the date on... filing a claim does not begin to run until the employee receives an audiogram with the accompanying...

Analysis of clinical negligence claims following tonsillectomy in England 1995 to 2010.

PubMed

Mathew, Rajeev; Asimacopoulos, Eleni; Walker, David; Gutierrez, Tatiana; Valentine, Peter; Pitkin, Lisa

2012-05-01

We determined the characteristics of medical negligence claims following tonsillectomy. Claims relating to tonsillectomy between 1995 and 2010 were obtained from the National Health Service Litigation Authority database. The number of open and closed claims was determined, and data were analyzed for primary injury claimed, outcome of claim, and associated costs. Over 15 years, there were 40 claims of clinical negligence related to tonsillectomy, representing 7.7% of all claims in otolaryngology. There were 34 closed claims, of which 32 (94%) resulted in payment of damages. Postoperative bleeding was the most common injury, with delayed recognition and treatment of bleeding alleged in most cases. Nasopharyngeal regurgitation as a result of soft palate fistulas or excessive tissue resection was the next-commonest cause of a claim. The other injuries claimed included dentoalveolar injury, bums, tonsillar remnants, and temporomandibular joint dysfunction. Inadequate informed consent was claimed in 5 cases. Clinical negligence claims following tonsillectomy have a high success rate. Although postoperative bleeding is the most common cause of negligence claims, a significant proportion of claims are due to rare complications of surgery. Informed consent should be tailored to the individual patient and should include a discussion of common and serious complications.

47 CFR 1.1167 - Error claims related to regulatory fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Challenges to determinations or an insufficient regulatory fee payment or delinquent fees should be made in writing. A challenge to a determination that a party is delinquent in paying a standard regulatory fee... 47 Telecommunication 1 2010-10-01 2010-10-01 false Error claims related to regulatory fees. 1.1167...

34 CFR 682.511 - Procedures for filing a claim.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) The repayment instrument. (iv) A payment history, as described in § 682.414(a)(3)(ii)(I). (v) A collection history, as described in § 682.414(a)(3)(ii)(J). (vi) A copy of the final demand letter if... America of all rights, title, and interest of the lender in the note underlying the claim. (d) Bankruptcy...

34 CFR 682.511 - Procedures for filing a claim.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) The repayment instrument. (iv) A payment history, as described in § 682.414(a)(3)(ii)(I). (v) A collection history, as described in § 682.414(a)(3)(ii)(J). (vi) A copy of the final demand letter if... America of all rights, title, and interest of the lender in the note underlying the claim. (d) Bankruptcy...

34 CFR 682.511 - Procedures for filing a claim.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) The repayment instrument. (iv) A payment history, as described in § 682.414(a)(3)(ii)(I). (v) A collection history, as described in § 682.414(a)(3)(ii)(J). (vi) A copy of the final demand letter if... America of all rights, title, and interest of the lender in the note underlying the claim. (d) Bankruptcy...

Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Final rule with comment period.

PubMed

2016-11-04

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), and will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies. In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders.

20 CFR 10.915 - What are the responsibilities of OWCP in the death gratuity payment process?

Code of Federal Regulations, 2013 CFR

2013-04-01

... responsibilities of OWCP in the death gratuity payment process? (a) If the death gratuity payment process is initiated by the employing agency's submission of form CA-42, OWCP will identify living potential claimants. OWCP will make a reasonable effort to provide claim form CA-41s to any known potential claimants and...

20 CFR 10.915 - What are the responsibilities of OWCP in the death gratuity payment process?

Code of Federal Regulations, 2014 CFR

2014-04-01

... responsibilities of OWCP in the death gratuity payment process? (a) If the death gratuity payment process is initiated by the employing agency's submission of form CA-42, OWCP will identify living potential claimants. OWCP will make a reasonable effort to provide claim form CA-41s to any known potential claimants and...

20 CFR 10.915 - What are the responsibilities of OWCP in the death gratuity payment process?

Code of Federal Regulations, 2011 CFR

2011-04-01

... responsibilities of OWCP in the death gratuity payment process? (a) If the death gratuity payment process is initiated by the employing agency's submission of form CA-42, OWCP will identify living potential claimants. OWCP will make a reasonable effort to provide claim form CA-41's to any known potential claimants and...

20 CFR 10.915 - What are the responsibilities of OWCP in the death gratuity payment process?

Code of Federal Regulations, 2010 CFR

2010-04-01

... responsibilities of OWCP in the death gratuity payment process? (a) If the death gratuity payment process is initiated by the employing agency's submission of form CA-42, OWCP will identify living potential claimants. OWCP will make a reasonable effort to provide claim form CA-41's to any known potential claimants and...

20 CFR 10.915 - What are the responsibilities of OWCP in the death gratuity payment process?

Code of Federal Regulations, 2012 CFR

2012-04-01

... responsibilities of OWCP in the death gratuity payment process? (a) If the death gratuity payment process is initiated by the employing agency's submission of form CA-42, OWCP will identify living potential claimants. OWCP will make a reasonable effort to provide claim form CA-41s to any known potential claimants and...

42 CFR 422.304 - Monthly payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... makes advance monthly payments of the amounts determined under paragraphs (a)(1) and (a)(2) of this... month. (1) Payment of bid for plans with bids below benchmark. For MA plans that have average per capita... benchmarks. The rebate amount under paragraph (a)(1)(ii) of this section is the amount of the monthly rebate...

42 CFR 422.304 - Monthly payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... makes advance monthly payments of the amounts determined under paragraphs (a)(1) and (a)(2) of this... month. (1) Payment of bid for plans with bids below benchmark. For MA plans that have average per capita... benchmarks. The rebate amount under paragraph (a)(1)(ii) of this section is the amount of the monthly rebate...

42 CFR 422.304 - Monthly payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... makes advance monthly payments of the amounts determined under paragraphs (a)(1) and (a)(2) of this... month. (1) Payment of bid for plans with bids below benchmark. For MA plans that have average per capita... benchmarks. The rebate amount under paragraph (a)(1)(ii) of this section is the amount of the monthly rebate...

Do Zero-Cost Workers’ Compensation Medical Claims Really Have Zero Costs?

PubMed Central

Asfaw, Abay; Rosa, Roger; Mao, Rebecca

2015-01-01

Objective Previous research suggests that non–workers’ compensation (WC) insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This study further examined GHI utilization and costs. Methods Using two-part model, we compared those outcomes immediately after injuries for which accepted WC medical claims made zero or positive medical payments. Results Controlling for pre-injury GHI utilization and costs and other covariates, our results indicated that post-injury GHI utilization and costs increased regardless of whether a WC medical claim was zero or positive. The increases were highest for zero-cost WC medical claims. Conclusion Our national estimates showed that zero-cost WC medical claims alone could cost the GHI $212 million per year. PMID:24316724

The seven elements of a payable claim.

PubMed

Liles, Robert W

2013-01-01

Healthcare providers are obligated to comply with a wide range of statutory and regulatory requirements associated with the provision, documentation, coding, and billing of a medical claim. It is important to keep in mind that the viewpoint of an outside auditor is not going to be the same as that of the treating physician. For instance, when documenting medical services, the information viewed as most significant (and therefore recorded) by a treating physician may be very different from the information an outside auditor hopes to glean from a patient's record. As a result, a significant disconnect between the parties may occur. To avoid this, it is essential that a treating physician or other healthcare provider diligently work to help ensure that claims submitted to Medicare, Medicaid, or a private payer fully comply with all applicable coverage and payment requirements. We have developed a checklist that we refer to as "The Seven Elements of a Payable Claim" to assist providers in this effort.

Resolving Malpractice Claims after Tort Reform: Experience in a Self-Insured Texas Public Academic Health System.

PubMed

Sage, William M; Harding, Molly Colvard; Thomas, Eric J

2016-12-01

To describe the litigation experience in a state with strict tort reform of a large public university health system that has committed to transparency with patients and families in resolving medical errors. Secondary data collected from The University of Texas System, which self-insures approximately 6,000 physicians at six health campuses across the state. We obtained internal case management data for all medical malpractice claims closed during 1 year before and 6 recent years following the enactment of state tort reform legislation. We retrospectively reviewed information about malpractice claimants, malpractice claims, and the process and outcome of dispute resolution. We accessed an internal case management database, supplemented by both electronic and paper records compiled by the university's Office of General Counsel. Closed claims dropped from 244 in 2001-2002 to an annual mean of 96 in 2009-2015, closures following lawsuits from 136 in 2001-2002 to an annual mean of 28 in 2009-2015, and paid claims from 60 in 2001 to an annual mean of 20 in 2009-2015. Patterns of resolution suggest efforts by the university to provide some compensation to injured patients in cases that were no longer economically viable for plaintiffs' lawyers to litigate. The percentage of payments relating to cases in which lawsuits had been filed decreased from 82 percent in 2001-2002 to 47 percent in 2009-2012 and again to 29 percent in 2012-2015, although most paid claimants were represented by attorneys. Unrepresented patients received payment in 13 cases closed in 2009-2012 (22 percent of payments; mean amount $60,566) and in 24 cases closed in 2012-2015 (41 percent of payments; mean amount $109,410). Even after tort reform, however, claims that resulted in payment remained slow to resolve, which was worsened for claimants subject to Medicare secondary payer rules. Strict confidentiality became a more common condition of settlement, although restrictions were subsequently relaxed

20 CFR 410.565 - Collection and compromise of claims for overpayment.